在心房动患者中诊断透支功能障碍和心力衰竭与保存的射出分数:临床挑战
Carmen C Beladan1,2, Francisco Gual-Capllonch3, Andreea C Popescu1,4
1Department of Cardiology, University of Medicine and Pharmacy 'Carol Davila' Sos. Fundeni 258, Sector 2, 022328 Bucharest, Romania.
European heart journal. Cardiovascular Imaging
|June 28, 2024
概括
左心室透静功能障碍和心房动往往导致心力衰竭与保存的喷射分数. 评估心房患者的透静功能对于早期HFpEF检测和管理至关重要.
科学领域:
- 心脏病学 心脏病学
- 心血管医学 心血管医学
背景情况:
- 左心室 (LV) 透析功能障碍,心房动 (AF) 和心力衰竭与保留喷射分数 (HFpEF) 是相互关联的心血管疾病.
- AF经常先于HFpEF,使得在AF患者中早期检测透气功能障碍至关重要.
研究的目的:
- 审查目前评估LV透气功能和诊断AF患者的HFpEF的方法.
- 讨论AF中心声扫描对扩张功能评估的挑战,并提出一个实际的方法.
主要方法:
- 审查现有的文献关于LV静脉动脉功能评估和AF中的HFpEF诊断.
- 讨论心声学参数,临床评价,尿和心脏导管.
- 介绍最近提出的两步算法,结合心声学和体重指数,用于AF中的LV填充压力评估.
主要成果:
- 由于周期长度的可变性和缺少心房收缩,标准的LV透气功能算法很难在AF中应用.
- 增加或正常的LV填充压力 (LVFPs) 的二进制评估是AF的合理临床目标.
- 一种新的两步算法显示,它有望在AF患者中区分正常和高LVFP.
结论:
- 综合评估包括心声回声,临床评估,尿素和可能的心脏导管是必要的HFpEF诊断在AF.
- 如果HFpEF诊断不确定,建议对可修改的风险因素进行密切跟踪和管理.
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