肝硬度作为预后参数和在晚期心脏转氨基粉症中风险分层的工具
Sandra Michaela Ihne-Schubert1,2,3,4, Caroline Morbach5,6,7, Oliver Goetze8,9
1Interdisciplinary Amyloidosis Center of Northern Bavaria, University Hospital of Würzburg, Würzburg, Germany. ihne_s@ukw.de.
概括
肝硬度预测了晚期心脏转激素粉化症 (ATTR-CA) 的死亡率. 这种非侵入性措施有助于风险分层,特别是在心脏功能受损的患者中.
科学领域:
- 心脏病学 心脏病学
- 医学诊断 医学诊断 医学诊断
- 氨基粉症研究研究
背景情况:
- 由于治疗方法的不断变化,风险分层对于晚期心脏转激素粉化症 (ATTR-CA) 是至关重要的.
- 肝硬度是液体过载和肝脏拥堵的标志物,可以预测ATTR-CA.中的死亡率.
研究的目的:
- 为了评估晚期ATTR-CA患者肝硬度的预后值.
- 为了确定肝硬是否可以帮助这种患者群体的死亡风险分层.
主要方法:
- 使用振动控制的短暂弹性图 (VTCE) 来测量肝硬度.
- 对AmyKoS队列研究数据进行了斯皮尔曼相关性和考克斯回归分析.
- 评估左心室全球纵向应变 (GLS) 和其他拥堵替代物.
主要成果:
- 研究了41名ATTR-CA患者 (平均年龄76.6岁,男性90.2%).
- 肝硬和左心室全球纵向应变 (GLS) 与死亡率有显著的相关性.
- 在GLS<10%的患者中,肝硬度更具差异性,而NT-proBNP在GLS≥10%的患者中预测了结果.
结论:
- 肝硬度在高级ATTR-CA.中显示出所有原因死亡率的预后价值.
- 肝硬度有助于风险分层,特别是在明显受损肝功能的患者中.
- 这些发现可转移到其他拥堵替代物,如肝静脉扩张和三腹吐峰值速度.
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