在低梯度大动脉狭窄症中,多布他胺应激回声心脏学
Nils Sofus Borg Mogensen1, Mulham Ali2, Rasmus Carter-Storch3
1Department of Cardiology, Odense University Hospital, Odense, Denmark; Institut Universitaire de Cardiologie et de Pneumologie de Québec (Québec Heart and Lung Institute), Laval University, Québec, Québec, Canada; Clinical Institute, University of Southern Denmark, Odense, Denmark.
在低梯度的大动脉狭窄 (AS) 时,当左心室喷射率 (LVEF) 为<35%时,多布他胺应激心声学 (DSE) 是准确的. 在LVEF≥35%的患者中,诊断准确性显著下降.
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.
- 心脏成像 - - 心脏成像
背景情况:
- 指导方针建议在低梯度大动脉狭窄症 (AS) 中进行多巴胺应激回声心电图 (DSE),左心室喷射率 (LVEF) <50%.
- 关于LVEF>35%的患者的DSE准确度的数据有限.
研究的目的:
- 评估低梯度AS中DSE的诊断准确度,在广泛的LVEF中进行评估.
- 调查DSE诊断准确度和LVEF之间的相互作用.
主要方法:
- 221名患有低梯度AS的患者接受了DSE和心脏计算机断层扫描 (C-CT).
- 根据LVEF对患者进行了分层:<35%,35%-50%和>50%.
- 严重的AS是由C-CT化得分来定义的.
主要成果:
- 对于严重的AS,当LVEF<35% (AUC=0.90) 时,DSE显示出高的诊断准确性.
- 对于LVEF≥35% (AUC从0.60到0.67) 的诊断准确性显著下降.
- 准则值为LVEF<50%的灵敏度为49%,特异性为84%.
结论:
- DSE是安全的,在低梯度AS患者中增加中风体积,无论LVEF如何.
- 在评估AS严重性的DSE准确性是异质的,并取决于LVEF,在LVEF患者中最高.
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