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心声图像质量随着心脏性休克的严重程度而恶化

Hazem Lashin^1,2, Francesco Vasques³, Sanjeev Bhattacharyya^4,5

¹Adult Critical Care Unit, Barts Heart Centre, St Bartholomew's Hospital, West Smithfield, London, EC1A 7BE, UK. h.lashin@qmul.ac.uk.

The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology

|August 23, 2024

概括

在心脏性休克 (CS) 患者中,用于评估左心室 (LV) 功能的胸前回声心脏成像 (TTE) 图像质量随着休克严重程度而恶化. 较低的心脏指数 (CI) 与较差的LV图像质量有关.

科学领域:

心脏病学心脏病学
关键护理医学关键护理医学
医疗成像医学成像

背景情况:

胸外回声心电图 (TTE) 对于评估心脏性休克 (CS) 中的左心室 (LV) 功能至关重要.
在TTE中图像质量的局限性可能会阻碍在重症患者中准确评估LV功能.
研究影响缺血性CS中TTE图像质量的因素对于改善患者管理至关重要.

研究的目的:

确定与患有缺血性CS患者的LV图像质量相关的因素.
确定TTE内心边界定义指数 (EBDi) 和临床参数之间的关系.
评估EBDi对CS患者心脏指数 (CI) 的预测值.

主要方法:

从100名重症监护室 (ICU) 患有ST升高心肌梗塞和CS的患者的TTEs的回顾性分析.
由两名重症监护医生对TTE进行独立审查,以使用标准化评分系统评估LV内心边界定义 (EBD).
双平面EBD指数 (EBDi) 的计算和与临床和心声学参数的相关性,包括CI,平均动脉压 (MAP) 和右心室功能指标.

主要成果:

中间双平面EBDi低于最佳 (1.833),表明图像质量降低.
EBDi显示与MAP,CI和右心室缩功能参数 (RV S',TR Vmax) 有显著的相关性.
在多变量分析中,只有CI与EBDi独立相关 (r2=0.105,p<0.01).
双飞机EBDi有效预测CI (AUC0.70,p=0.001) 具有71%的灵敏度和61%的特异性.

结论:

通过TTE评估的LV图像质量随着冲击严重程度的增加而恶化,如心脏指数 (CI) 的较低所示.
双平面EBDi作为一个有价值的,尽管不完美,CI的预测器在患有缺血性CS的患者.
这些发现强调了冲击严重程度对心声回声评估的影响,并建议EBDi作为血液动力学状态的潜在代用标记物.

关键词:

心脏发生的冲击是心脏的冲击.心声回声扫描 (Echocardiography) 是一种心声回声扫描.图像质量图像质量心肌梗塞的心脏病发作

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