作为临床结果的预测者,左心室和右心室之间的不同中风体积:MESA研究
Ashkan Abdollahi1, Yoko Kato1, Hooman Bakhshi1
1From the Division of Cardiology, Department of Medicine (A.A., Y.K., H.B., V.V., O.C., R.Z., M.R.O., J.A.C.L.), and Department of Radiology (B.A.V.), Johns Hopkins University, 600 N Wolfe St, Baltimore, MD 21287-0409; Office of Biostatistics Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md (C.O.W.); Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC (A.G.B.); Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (S.J.S.); and Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.).
与右心室中风体积相比,左心室中风体积较高的无症状个体面临死亡率,心力衰竭和心房的风险增加. 这一发现突显了心血管健康中不同腹腔中风体积的预后价值.
科学领域:
- 心脏病学 心脏病学
- 医疗成像医学成像
- 预防医学 预防医学
背景情况:
- 膜性心脏病和心内短路会导致左心室 (LV) 和右心室 (RV) 中风体积的失衡.
- 在无症状个体中,这些心室失衡的预后意义仍然不清楚.
研究的目的:
- 通过心脏MRI测量不同的室腔中风体积与没有先前心血管疾病的个体的临床结果之间的关联.
主要方法:
- 一项前性队列研究的二次分析,涉及4058名没有心血管疾病的参与者.
- 用心脏MRI量化LV和RV中风体积,计算差异.
- 参与者被分为平衡的,负的或正的差异性中风体积组.
- 多变量Cox比例危险回归模型评估了差异性中风体积和不良结果之间的联系.
主要成果:
- 与平衡体积相比,差异性中风体积增加 (LV SV > RV SV>30毫升) 与较高的死亡风险 (HR,1.73),心力衰竭 (HR,2.40) 和心房动 (HR,1.89) 相关.
- 降低差异性中风体积 (<-30毫升) 显示了心力衰竭的初始风险增加,在调整为LV功能后,这种风险并不显著.
- 该研究追踪了4058名参与者,平均时间为18.4年,观察了1006例死亡,235例心力衰竭病例和764例心房动病例.
结论:
- 无症状的个体,左心室中风体积超过右心室中风体积超过30毫升,死亡率,心力衰竭和心房动的风险增加.
- 通过心脏MRI量化微分心室中风体积,在无症状人群中提供预后价值.
- 这些发现强调了在心血管风险分层中评估心室平衡的重要性.
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