成年人与先天性 Septal 缺陷和 Paroxysmal 心房的左心房结构和功能变化
Anton V Minaev1, Marina Yu Mironenko1, Vera I Dontsova1
1A.N. Bakoulev National Medical Research Center of Cardiovascular Surgery, 121552 Moscow, Russia.
Journal of clinical medicine
|October 16, 2024
概括
患有隔膜缺陷和心房动 (AF) 的成年人显示左心房 (LA) 功能发生变化. 关键的AF预测指标包括LA体积指数,储菌株和收缩菌株,这表明LA功能评估有助于临床管理.
科学领域:
- 心脏病学 心脏病学
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
- 心脏电生理学 心脏电生理学
背景情况:
- 先天性隔膜缺陷可能导致心脏血液动力学变化.
- 心房动 (AF) 是一种常见的心律失常,其在隔膜缺陷患者的发展需要进一步调查.
- 左心房 (LA) 的结构和功能在AF的病理生理学中至关重要.
研究的目的:
- 使用LA体积和功能的参数,区分患有隔膜缺陷和阳性AF的成年患者和没有心律失常的患者.
- 为了确定与该患者群体中AF发展相关的特定LA参数.
- 评估LA功能评估对预测AF的潜力.
主要方法:
- 一项前性研究,包括81名患有隔膜缺陷和左至右分流的成年患者.
- 患者被分为两组:患有偏发性AF (n=26) 和没有AF (n=55).
- 左心房功能使用斑点跟踪回声心脏学评估,分析索引体积 (LAVI, preA-LAVI),射出分数 (LAEF),膨胀指数 (LAEI),储 (LAS-r),导管 (LAS-cd),收缩性 (LAS-ct) 应变和刚度指数 (LASI).
主要成果:
- 在所有LA功能参数中,在有AF和没有AF的患者之间观察到显著的差异.
- 统一分析确定了与AF相关的LAVI,pre-A-LAVI,LASI,LAEF,LAEI,LAS-r,LAS-c,LAS-ct,年龄,心脏指数,E/A和RV压力.
- 多变量分析显示LAVI (OR 1.236),LAS-r (OR 0.723) 和LAS-ct (OR 1.518) 作为AF的独立预测因素. 一个预测模型显示高准确度 (AUC:0.97).
结论:
- 在患有先天性隔膜缺陷的患者中,斑点跟踪回声心脏学揭示了显著不同的LA功能参数,这些患者患有AF.
- 在这个队列中,LA体积指数,储菌株和收缩菌株是AF发展的独立预测因素.
- 使用这种技术进行LA功能评估是一种有价值的工具,可以纳入隔膜缺陷患者的常规临床管理.
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