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根据初始临床表现分层的肌心炎的预后: "中间"风险仍然发挥作用吗?
Daniela Di Lisi1,2, Cristina Madaudo1,2, Maria Gabriella Carmina3
1Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE) University of Palermo, Italy.
American heart journal plus : cardiology research and practice
|September 23, 2024
概括
中等风险心肌炎患者的结果与低风险患者的结果相似,这表明晚期加多增强在心脏MRI上预测不良事件. 这一发现有助于了解心肌炎的预后.
科学领域:
- 心脏病学 心脏病学
- 心血管成像 - 心血管成像
- 炎症性疾病 炎症性疾病
背景情况:
- 肌心炎是一种炎症性心脏病,呈现出各种各样的临床结果.
- 患有心肌炎的高风险患者的预后比低风险患者差.
- 对于中等风险心肌炎患者的长期预后存在有限的数据.
研究的目的:
- 分析不同风险概况的急性心肌炎患者的长期结果.
- 专门研究急性心肌炎中等风险患者的预后.
- 确定心肌炎中心血管不良事件的预测参数.
主要方法:
- 对127名临床怀疑急性心肌炎的患者进行了回顾性多中心研究.
- 根据Sinagra的分类,将风险分为高,中,低的风险分层.
- 评估心血管不良事件 (AE) 在19个月的中位数随访使用心声学和心磁共振 (CMR).
主要成果:
- 与中等/低风险组 (16%) 相比,高风险组的患者经历了显著更多的副作用 (80%).
- 在基线CMR和AE发生时,晚期加多增强 (LGE) 分段的数量之间发现了显著的关联 (p < 0.0037).
- 增加的LGE段与左心室全球纵向应变 (GLS) 的减少相关 (p < 0.009).
结论:
- 该研究证实,高风险心肌炎患者的AE发病率更高.
- 中等风险心肌炎患者的预后与低风险患者相似.
- 在基线CMR上LGE的程度被假设为中等风险患者中AEs的关键预测因素.
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