左心室扩张性功能障碍预测了外科动脉置换术后全球纵向应变恢复
Francesca Bonanni1,2, Sabina Caciolli1, Martina Berteotti1,3
1Division of General Cardiology, Department of Cardiac, Thoracic and Vascular Medicine, Azienda Ospedaliero-Universitaria Careggi, 50134 Florence, Italy.
Diagnostics (Basel, Switzerland)
|October 16, 2024
概括
在患有严重的大动脉狭窄和保留射出分数的患者中,大动脉置换手术 (SAVR) 会导致全球纵向应变 (GLS) 的初始下降. 经过12个月,GLS会有所改善,特别是在轻度扩张功能障碍的患者中.
科学领域:
- 心脏病学 心脏病学
- 心血管外科心血管外科
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
背景情况:
- 严重的大动脉狭窄症 (AS) 通常需要进行大动脉置换手术 (SAVR).
- 左心室缩功能障碍预测SAVR后的不良事件,但许多患者现在接受了保留功能的手术.
- 全球纵向应变 (GLS) 是这些患者在SAVR后心室重塑的潜在标志物.
研究的目的:
- 为了评估SAVR后GLS的变化,在AS和保存的喷射分数 (EF) 的患者中.
- 根据手术前扩张功能障碍的严重程度来比较GLS变化.
主要方法:
- 在2020年6月至2023年3月期间,有108名AS和保存EF患者接受SAVR治疗.
- 心声学评估了手术前,手术后7天和手术后12个月的GLS.
- 患者被分为A组 (扩张性功能障碍I级) 和B组 (II-III级).
主要成果:
- 手术后的GLS显著下降 (16 ± 4.3%至12.8 ± 3.4%,p < 0.0001).
- 12个月后,GLS在两组都得到改善 (A组:17.7 ± 3.4%,B组:15.7 ± 3.2%,p < 0.0001).
- 仅在A组 (轻微的腹功能障碍) 观察到与基线相比GLS显著改善.
结论:
- 在LVEF保存的患者中,SAVR会导致GLS的早期减少,而不管透支功能障碍的严重程度如何.
- 在SAVR后12个月发生了显著的GLS恢复.
- 患有轻度扩张功能障碍的患者表现出最实质性的GLS恢复.
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