在患有慢性严重大动脉反的患者中对左心房重塑的纵向评估
Emmanuel Akintoye1, Joseph El Dahdah2, M Marwan Dabbagh3
1Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA; Section of Cardiovascular Imaging, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA.
JACC. Cardiovascular imaging
|June 15, 2024
概括
左心房 (LA) 改造参数,包括LA体积指数 (LAVI) 和LA储菌株 (LAr),在患有大动脉吐 (AR) 的患者中,在性别和年龄组之间呈现一致的进展. 与左心室 (LV) 参数相比,这些LA指标可以更好地预测不良事件.
科学领域:
- 心脏病学 心脏病学
- 心声回声图 (Echocardiography) 是一种心声回声图.
- 进行心脏重塑.
背景情况:
- 左心室 (LV) 改造中的性别和年龄差异可能会影响大动脉吐 (AR) 的结果.
- 目前对AR干预时间的标准可能无法完全解释这些人口变化.
- 需要新的参数来优化不同患者群体的干预时间.
研究的目的:
- 评估左心室 (LA) 参数作为AR干预时间的优越标准,与LV参数相比.
- 评估不同性别和年龄组的LA体积指数 (LAVI) 和LA储菌株 (LAr) 的纵向趋势.
- 为了确定LA参数相对于LV参数在预测不良事件中的增量预后效用.
主要方法:
- 从525名中度至重度或重度AR患者 (2010-2016年) 的序列心声扫描数据的分析.
- 评估LAVI和LAR的纵向趋势,按性别和年龄分层.
- 对不良事件的LA参数的预测值的评估,独立于LV参数.
主要成果:
- 随着时间的推移,LAVI显著增加 (1.0mL/m2/年),LAr显著下降 (-1.3%/年),不论性别或年龄.
- 无论是LAVI还是LAr都独立预测了不良事件,最佳值分别为37mL/m2和35%.
- 在LAVI≥37mL/m2或LAr≤35%的患者中,手术与生存益处相关.
结论:
- 在AR患者中,左心房改造在不同性别和年龄组中进展相似,与LV改造不同.
- LA参数 (LAVI和LAR) 为AR管理提供了超越LV参数的增量预测价值.
- 在更广泛的患者群体中,LA参数可以作为指导AR干预时间的更可靠标准.
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