在老年人中,左心房功能和偶发性心力衰竭
Carlo Mannina1, Kazato Ito2, Zhezhen Jin3
1Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York; Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
概括
左心房合指数预测了老年人心力衰竭的发展. 这一指标比左心房体积和压力更强有力的预测指标,改善了风险评估.
科学领域:
- 心脏病学 心脏病学
- 老年病的医生 老年病的医生
- 心声回声图 (Echocardiography) 是一种心声回声图.
背景情况:
- 心力衰竭 (HF) 越来越普遍,特别是在老年人群中.
- 左心房 (LA) 功能障碍与HF有关,但其在HF发展中的预测作用尚未完全理解.
- 这项研究研究了LA功能的预测新发的HF在没有先前心血管事件的老年人的能力.
研究的目的:
- 确定左心房 (LA) 功能的测量是否可以预测55岁及以上成年人心力衰竭 (HF) 的发生率.
- 为了比较各种LA功能参数的预测能力,包括体积,应变,刚度和LA合指数 (LACI),对于事件HF.
- 评估LA函数对HF发展的独立预测值,根据已确定的心血管风险因素进行调整.
主要方法:
- 研究了一组795名年龄≥55岁的成年人,没有先前的心血管事件.
- 心声学 (标准,3D,斑点跟踪) 用于测量LA体积,应变,刚性和LACI.
- 参与者被跟踪平均11.4年新发性HF,通过采访,访问和医院记录监测进行确认.
主要成果:
- 在随访期间,新发性HF发生在43.4%的参与者中.
- 所有评估的LA形态和功能测量都与发生的HF有关 (P < .05).
- 在多变量分析中,LA硬度和LACI独立地与发生的HF相关. 在调整左心室全球纵向应变后,只有LACI仍然是一个显著的预测因素.
结论:
- 左心室合指数 (LACI) 是老年人发生心力衰竭的重要独立预测指标.
- 与传统的LA体积和应变测量相比,LACI显示出对HF发展的优越预测能力.
- 将LACI纳入风险评估模型可能会提高老年人群中HF风险的分层.
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