使用前性心电图触发的心脏CTCT来预测缩左心室射出分数的预后值
Yoshito Kadoya1, Mehmet Onur Omaygenc1, Shahin Sean Abtahi1
1Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario, K1Y 4W7, Canada.
一个新的指数,左心室射出分数超过100毫秒 (LVEF100msec),显示了心脏CT扫描中的预后价值. 较低的LVEF100msec可以预测主要的不良心血管事件,改善风险评估.
科学领域:
- 心脏病学 心脏病学
- 医疗成像医学成像
- 生物统计学 生物统计学
背景情况:
- 预期的ECG触发的心脏CT成像在评估左心室 (LV) 喷射率 (EF) 方面存在局限性.
- 开发了一种新型指数,LVEF100msec,用于估计从静脉缩100毫秒内的静脉缩体积变化中LV功能.
- 在接受心脏CT的患者中,LVEF100msec的预后能力需要进一步评估.
研究的目的:
- 评估LVEF100msec在预测主要不良心血管事件 (MACE) 中的预后价值.
- 为了确定LVEF100msec的最佳切断值,以识别高风险患者.
- 为了研究LVEF100msec与心血管结果的关联,在接受潜在的ECG触发心脏CT的患者中.
主要方法:
- 分析了一组313名接受前性静脉心电图触发心脏CT的患者.
- 每个患者的LVEF100msec都被计算出来.
- 用曲线分析下的面积和Cox比例危险模型来确定最佳的LVEF100msec切线并预测MACE.
主要成果:
- 总共有24名患者 (7.7%) 在中位数924天的随访期间经历了MACE.
- 与没有 (8.3%,p=0.002) 的患者相比,MACE (4.8%) 的患者的LVEF100msec显著较低 (8.3%,p=0.002).
- 独立预测MACE的LVEF100msec截止值为6.3% (调整HR为3.758,p=0.004),较低的值与减少的MACE无生存时间相关.
结论:
- LVEF100msec作为不良心血管事件的独立预测器.
- 将LVEF100msec纳入潜在的ECG触发的心脏CT分析可以提高预后准确性.
- 该指数为心脏CT成像中的风险分层提供了有价值的工具.
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