在心律失常性右心室心肌病症中的右心筋应变:对心血管结局的影响
Shehab Anwer1,2, Lauren Stollenwerk1,3, Neria E Winkler1,2
1Department of Cardiology, University Heart Center, University Hospital Zürich and University of Zürich, Raemistrasse 100, 8091 Zürich, Switzerland.
European heart journal. Cardiovascular Imaging
|April 29, 2024
概括
损伤的右心室和心房应变与心律失常性右心室心肌病患者的不良心血管事件有关. 这些测量提高了风险预测,建议将它们纳入ARVC的常规心声回声学.
科学领域:
- 心脏病学 心脏病学
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
- 心血管成像 - 心血管成像
背景情况:
- 节律失调性右室心肌病 (ARVC) 是一种遗传性心脏病,导致渐进性功能障碍并增加主要心血管事件的风险.
- 评估心脏右侧应变对于理解ARVC进展和患者结果至关重要.
研究的目的:
- 在ARVC患者中评估右心室全球纵向应变 (RVGLS) 和右心房全球纵向应变 (RAGLS).
- 在随访期间确定RVGLS和RAGLS与心血管不良事件的关联.
主要方法:
- 用TomTec ImageArena对70名ARVC患者进行了聚焦的右心角视图分析.
- 测量了全球纵向应变 (RVGLS和RAGLS).
- 与复合终点 (持续性心室节律失常和心血管死亡) 的关联在4.9年的中位随访期内进行了评估.
主要成果:
- 与没有事件的患者相比,经历不良事件的患者显示RVGLS和RAGLS显著受损 (P <0.001两者).
- 在Cox回归分析中,RVGLS和RAGLS都独立地与不良事件风险增加有关.
- 当RVGLS和RAGLS一起使用时,它们提供了超越常规参数的增量预测值,并改善了模型适应性.
结论:
- 减少RVGLS和RAGLS表明ARVC患者的不良结果.
- 这些菌株参数是不良事件的独立预测因素,即使考虑到年龄,性别和传统的RV措施.
- 将RVGLS和RAGLS纳入ARVC的常规回声心脏图谱协议可能会提高风险分层和患者管理.
相关概念视频
01:26Imbalances in Cardiac Output
1.4K
The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
1.4K
01:28Mechanism of Cardiac Arrhythmias
917
Arrhythmias are irregular heart rhythms occurring when the heart's electrical impulses become abnormal. These disturbances can lead to various symptoms, depending on their severity and the underlying cause. Some common factors contributing to arrhythmias include hypoxia, ischemia, electrolyte imbalances, excessive catecholamine exposure, drug toxicity, and muscle overstretching. Arrhythmias can be classified into two main types based on the rate and site of origin of abnormal heart rhythms.
917
01:28Disturbances in Heart Rhythm
945
Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow...
Arrhythmias are categorized by their speed, rhythm, and origin. A slow...
945
01:29Pathophysiology of Cardiac Performance
644
Typical heart performance is influenced by heart rate, rhythm, myocardial contraction, and metabolism or blood flow. The cardiac muscle exhibits distinct electrophysiological features, including pacemaker activity and calcium channel control, which play a vital role in the heart's response to various drugs. The autonomic nervous system, comprising the sympathetic and parasympathetic branches, regulates heart rate. Sympathetic activation increases heart rate, while parasympathetic activation...
644