根据身体表面积调整心房尺寸参数:它是否会影响与肺栓塞相关不良事件的关联?
Rachael R Kirkbride1, Galit Aviram2, Benedikt H Heidinger1,3
1Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
Journal of thoracic imaging
|April 18, 2024
概括
身体表面积 (BSA) 索引并没有显著改变左心房 (LA) 测量肺栓塞 (PE) 不良事件的预测能力. 左心房体积仍然是最强的预测因素,但LA短轴直径具有类似的临床实用性.
科学领域:
- 心脏病学 心脏病学
- 放射学 放射学是一门学科.
- 肺部医学 肺部医学
背景情况:
- 小左心房 (LA) 容量是急性肺栓塞 (PE) 中不良事件的已知预测因素.
- 身体表面积 (BSA) 索引对PE相关不良事件 (AE) 的心房测量预测值的影响尚未得到充分证实.
研究的目的:
- 评估BSA-索引对计算机断层扫描 (CT) 导出的心房测量对预测PE相关AE的影响.
- 为了比较索引与非索引心房测量对急性PE结果的预测性表现.
主要方法:
- 通过CT肺血管造影 (CTPA) 诊断的490名急性PE患者的回顾性审查.
- 从CTPA测量右和左心房体积,面积和直径.
- 心房测量 (指数化和非指数化BSA) 与30天PE相关AE (先进治疗或死亡率) 的相关性.
- 接收器运行特征曲线 (AUC) 下的面积分析以评估预测值.
主要成果:
- 无论是BSA指数和非指数的LA体积,面积和直径都与PE相关的AE显著相关.
- 预测AE的AUC值在索引和非索引测量之间是相似的.
- LA体积表现出最高的预测能力 (BSA指数AUC=0.68,非指数AUC=0.66),其次是LA短轴直径和LA面积.
结论:
- BSA-索引并没有显著提高30天PE相关AE的心房测量的预测能力.
- 在临床实践中,对于这些测量,BSA调整是不必要的.
- LA体积是最好的预测指标,但LA短轴直径提供了可比的预测值,并且在临床上更实用.
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