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以心声学计算的Fontan Fenestration梯度和以导管为基础的测量结果的比较

Emily Noel Sanders¹, Jim Zhongning Chen², Timothy Nissen³

¹Department of Pediatrics (Cardiology), University of Arkansas for Medical Sciences and Arkansas Children's Hospital, 1 Children's Way, Little Rock, AR, 72202, USA. esanders@uams.edu.

Pediatric cardiology

|October 12, 2024

概括

多普勒超声波衍生的平均化梯度 (mFG) 与Fontan患者的直接肺间梯度 (TPG) 测量有很弱的相关性. 在解释mFG时建议谨慎,因为它只解释了38%的TPG差异.

科学领域:

儿童心脏病学儿童心脏病学
遗传性心脏病是一种先天性心脏病.
心脏生理学心脏生理学

背景情况:

单心室解剖学需要分阶段的手术缓解,最终达到Fontan程序.
丰坦手术涉及到一个窗体,以促进静脉回归.
通过 fenestration 通过多普勒超声波估计跨肺梯度 (TPG) 是一种非侵入性评估方法.

研究的目的:

为了评估多普勒衍生平均化梯度 (mFG) 和以导管为基础的TPG测量之间的关系.
为了确定mFG在估计TPG的准确性,在患者 fenestrated Fontans.

主要方法:

追溯性队列研究,对59名患者进行 fenestrated Fontans (2000-2022年).
主要结果:以导管为基础的TPG测量.
主要预测因子:在导管注射后6个月内从心声学中获得的mFG.
统计分析:线性回归和R平方来评估相关性.

主要成果:

在导管衍生的TPG和mFG之间存在弱相关性 (R ² = 0.382,p < 0.001).
回归分析表明TPG=0.55 [mFG]+1.92. 这是一个很好的结果.
在患有全身左心室的患者中观察到稍微更强的预测关系 (R ² = 0.47,p < 0.004).

结论:

平均化梯度 (mFG) 解释了大约38%的导管衍生TPG的变异.
在Fontan患者中进行非侵入性mFG评估需要谨慎的解释.
通过心脏导管直接测量TPG仍然是黄金标准.

关键词:

一个心声回声图 (Echocardiogram) 是一个心声回声图.这里是Fontan Fontan.肺血管阻力肺血管阻力跨肺的梯度渐变.

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