在心房开关修复后,通过心肌工作分析评估下右心室功能
Ana Moya1,2, Sofie Verstreken3, Dimitri Buytaert2
1CardioPath PhD Program, Federico II University Hospital, Naples, Italy.
International journal of cardiology. Congenital heart disease
|December 23, 2024
概括
在大动脉 (D-TGA) 的 dextro-transposition 中末/Senning 修复后延长 QRS 持续时间与右下风室 (sRV) 性能恶化有关,特别是隔膜壁. 心肌工作指数 (MW) 可能有助于检测早期功能衰退.
科学领域:
- 心脏病学 心脏病学
- 儿童心脏病学 儿童心脏病学
- 心脏外科手术 心脏外科手术
背景情况:
- 对于D-TGA而言,末和森宁手术会创建一个下风右心室 (sRV).
- 长时间的QRS持续时间是已知的D-TGA患者的负预后因素.
- 目前的心声回声学在评估SRV性能下降后修复时存在局限性.
研究的目的:
- 在末/森宁修复后的D-TGA患者中表征心肌工作 (MW) sRV指数.
- 使用MW指数调查QRS持续时间和sRV功能之间的关联.
- 探索MW分析在检测亚临床sRV功能障碍中的实用性.
主要方法:
- 在Mustard/Senning修复后对成年D-TGA患者 (2018-2022) 的回顾性分析.
- 收集心电图参数,心声图像和血清生物标志物.
- 线下计算MW指数和与临床变量的相关性;根据QRS持续时间 (<120毫秒对≥120毫秒) 分类的患者.
主要成果:
- 包括51名D-TGA患者;QRS持续时间与sRV尺寸和NT-proBNP/热素水平相关.
- 没有发现QRS持续时间和心室内失调或常规回声参数之间的显著相关性.
- QRS延长 (≥120毫秒) 与隔膜MW受损,心室扩大和生物标志物升高有关.
结论:
- 末/森宁修复后的QRS延长表明心室扩张和sRV性能受损,特别是影响隔膜壁.
- 全球和区域MW分析显示,对评估亚临床sRV功能恶化有希望.
- 兆瓦指数为手术修复后D-TGA患者的监测提供了一个有价值的工具.
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