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胸腔挖掘对双心脏力学的影响:系统性审查和元分析

Andrea Sonaglioni¹, Valeria Fagiani², Gian L Nicolosi³

¹Division of Cardiology, MultiMedica IRCCS, Milan, Italy - sonaglioniandrea@gmail.com.

Minerva cardiology and angiology

|September 24, 2024

概括

胸腔挖掘 (PE) 显著影响右心室 (RV) 机制,而不是左心室 (LV) 机制. 心声图和心脏MRI可以检测PE患者微妙的双心脏损伤.

科学领域:

心脏病学心脏病学
医疗成像医学成像
生物物理学的生物物理.

背景情况:

胸腔挖掘 (PE) 是一种先天性胸壁形,影响心脏功能.
之前的研究探讨了PE对双腹力学的影响,使用特征追踪 (FT) 心血管磁共振成像 (CMR) 和斑点追踪回声心脏图像 (STE).
需要巩固PE对左心室 (LV) 和右心室 (RV) 全球纵向应变 (GLS) 影响的研究结果.

研究的目的:

系统地审查和对PE患者双心室力学现有研究进行元分析.
确定PE对LV-GLS和RV-GLS的整体影响.
为了比较PE对RV和LV机械的影响.

主要方法:

在PubMed和EMBASE的系统文献搜索中,对比PE个体与健康对照者的研究.
包括评估双心室大小,功能和心肌菌株参数的研究.
使用随机效应模型的标准化平均差异 (SMD) 对LV-GLS和RV-GLS的元分析;使用NIH质量评估评估的偏差风险.

主要成果:

分析了7项涉及374名PE患者和141名对照者的研究.
与对照组相比,PE患者的LV-GLS和RV-GLS都显著降低.
心声学研究显示LV-GLS和RV-GLS显著受损,而CMR研究没有达到统计意义;整体分析表明对RV-GLS有显著影响,但对LV-GLS没有显著影响.

结论:

胸部挖掘器对RV机械有更大的影响,而不是对LV机械.
STE和FT-CMR是检测PE中微妙的双心脏机械损伤的宝贵工具.
在STE中的方法因素可能会放大心肌应变指数观察到的减弱.

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