压力与体积超负荷的比较 心室壁压力 在患有膜心脏病的患者中
Stavroula Papapostolou1, John Kearns2, Benedict T Costello3
1Heart Centre, The Alfred Hospital, Melbourne, Victoria, Australia; Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia; Western Health, Melbourne, Victoria, Australia.
Journal of the American College of Cardiology
|August 7, 2024
概括
过导管大动脉置换 (TAVR) 在大动脉狭窄患者中显著降低了缩左心室壁应力 (LVWS). 米特拉克利普 (MC) 干预急性降低了米特拉吐患者的透性LVWS.
科学领域:
- 心脏病学 心脏病学
- 心血管成像 - 心血管成像
- 干预心脏病学 干预心脏病学
背景情况:
- 大动脉狭窄 (AS) 和额头回 (MR) 诱导不同的左心室重塑模式.
- 了解左心室壁应力 (LVWS) 对于表征这些疾病至关重要.
研究的目的:
- 在压力 (AS) 和体积 (MR) 超负荷方面描述LVWS配置文件.
- 检查基线LVWS和心脏重塑之间的关系.
- 评估门干预对LVWS的急性影响.
主要方法:
- 联合侵入性血液动力学与心磁共振 (CMR) 在47个AS (TAVR) 和15个MR (MC) 患者中.
- 在跨导管大动脉置换 (TAVR) 和MitraClip (MC) 之前和之后测量LVWS.
- 与6分钟步行测试 (6MWT) 和重塑参数相关的基线LVWS.
主要成果:
- TAVR显著降低了缩性 LVWS (24.7 Pa 到 17.3 Pa; P < 0.001).
- 麦克显著降低了透析LVWS (6.4Pa到4.3Pa;P=0.021),而静脉LVWS没有变化.
- 在TAVR患者中,较高的缩性LVWS基线与6MWT相反相关 (r = -0.31;P = 0.04).
结论:
- 在严重的大动脉狭窄时,TAVR急性降低了缩性LVWS.
- 在严重的甲骨管吐中,MC急性降低了透析性LVWS.
- 在AS中基线缩性LVWS升高可能表明早期失补偿并影响功能能力.
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