在非缺血性扩张性心肌病中,左心房应变:预后含义和与左心室变形的相互关系
Eduard Ródenas-Alesina1, Jordi Lozano-Torres1, Clara Badia-Molins1
1Department of Cardiology, Vall d'Hebron University Hospital, Department of Medicine, Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 119-129, 08035 Barcelona, Spain.
International journal of cardiology
|November 23, 2024
概括
左心房收缩应变 (PACS) 是非缺血性扩张性心肌病 (NIDCM) 中不良事件的关键预测因素. 较低的PACS值表明风险更高,特别是与左心室全球纵向应变 (LV-GLS) 相结合时.
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.
- 心脏衰竭研究研究
背景情况:
- 左心房 (LA) 变形分析有助于在非缺血性扩张性心肌病 (NIDCM) 中对不良事件的风险分层.
- 在NIDCM中评估峰值纵向应变 (PALS) 和峰值心房收缩应变 (PACS) 对于理解心脏功能至关重要.
研究的目的:
- 在NIDCM患者中确定PALS和PACS之间的关联.
- 为了评估这一关联,同时考虑左心室全球纵向应变 (LV-GLS).
主要方法:
- 包括连续NIDCM患者的鼻节律和LVEF<50%.
- 使用心声学测量PALS,PACS和LV-GLS.使用心声学.
- 使用考克斯回归和分类和回归树 (CART) 分析进行结果评估.
主要成果:
- 综合结局发生在20.2%的患者中,随访时间中位数为3.6年.
- PACS ≤8%与复合结果 (HR=2.73) 有显著的关联,主要是由心力衰竭入院驱动的.
- 在PACS>8% (HR=1.20) 的患者中,LV-GLS增加了复合结局风险.
- 比起PACS (rho=-0.5),PALS与LV-GLS的相关性更强 (rho=-0.71),而不是PACS (rho=-0.5).
- 降低PALS/LV-GLS比率与更高的综合结果率有关.
结论:
- 在NIDCM患者中,LA功能障碍是不良结果的主要决定因素,LVEF<50%.
- 建议对LA菌株进行常规评估.
- 当与LV-GLS相结合时,PACS可能比PALS更有效的预测器,这可能是由于对友节环状运动的依赖性减少.
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