在密码性中风患者中使用二维斑点跟踪回声心脏学评估左心房功能
Amr Setouhi1, Tarek Mohamed Abdelrahman2, Ahmed Mohamed Ali2
1Department of Cardiology, Faculty of Medicine, Minia University, Minya, Egypt. amr_setouhi@yahoo.com.
概括
通过2D-STE评估的左心房功能障碍与密码性中风有关. 左心房应变率 (LASr) 是这些患者亚临床心房动 (AF) 的敏感预测指标.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 医疗成像医学成像
背景情况:
- 在评估后,密码性脑血管中风缺乏明确的原因,与源不明的栓塞性中风 (ESUS) 区别开来.
- 评估左心房 (LA) 功能可能会揭示与密码性中风的联系,并预测亚临床心房动 (AF).
研究的目的:
- 在患有密码性中风的患者中,使用二维斑点跟踪心声学 (2D-STE) 评估左心房 (LA) 功能.
- 为了确定LA功能障碍和密码性中风之间的关联.
- 评估LA功能障碍对亚临床心房动 (AF) 的预测价值.
主要方法:
- 一项前性队列研究包括62名脑血管中风或TIA不明原因的患者.
- 患者接受过食道横断心声扫描 (TEE);22人因已确定的心血管栓塞而被排除在外.
- 其余的40名患者 (I组) 与40名健康对照 (II组) 进行了比较,使用2D跨胸部心声学和2D-STE.
主要成果:
- 在密码性中风患者和对照者之间观察到LA功能障碍参数 (LAVI,LAEF,LASr) 的显著差异.
- 左心房应变率 (LASr) 是最敏感和最具特异性的AF预测指标 (切断值≤24.5%).
- 左心房空化功能 (LAEF) 和左心房体积指数 (LAVI) 也预测了AF,但灵敏度和特异性较低.
结论:
- 2D-STE对于评估密码性中风中的LA功能障碍至关重要,特别是在排除心血管栓塞源之后.
- LASr是LA心脏病的关键指标,也是AF的独立预测因子,甚至在AF检测之前.
- 虽然LAEF和LAVI是显著的,但LASr在预测该人群中AF方面表现出更高的灵敏度和特异性.
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