节律失调的右心室心肌病:双心室应变在风险分层中的重要性
Aileen Paula Chua1, Dorien Laenens1, Camille Sarrazyn1
1Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Leiden, The Netherlands.
The American journal of cardiology
|January 13, 2025
概括
评估右室和左室功能的应变成像可以改善心律失常性右室心肌病 (ARVC) 的风险分层. 缺陷的双心膜应变表明ARVC患者的结果更差.
科学领域:
- 心脏病学 心脏病学
- 医疗成像医学成像
- 遗传学 是一个遗传学.
背景情况:
- 节律失调的右心室心肌病 (ARVC) 主要是右心室 (RV) 疾病,但左心室 (LV) 的参与越来越被认可.
- 目前的ARVC诊断依赖于以RV为中心的任务组标准 (TFC) 使用心声回声.
- 与常规心声回声相比,应变成像可以提高检测RV和LV功能障碍的灵敏度.
研究的目的:
- 为了评估结合LV全球纵向菌株 (GLS) 和VR自由壁菌株 (FWLS) 在ARVC患者风险分层的预后价值.
- 为了确定双心室菌株分析是否增加了超出既定标准的增量预后信息.
主要方法:
- 对204名ARVC患者进行了回顾性分析,他们接受了TFC.
- 根据双心室应变,患者被分为三组:受损 (RV和LV),不和 (一个受损) 和正常.
- 综合终点包括全因死亡率,心律失常事件,ICD治疗和心力衰竭事件,平均随访时间为87个月.
主要成果:
- 在三个菌株组中观察到无事件生存的显著差异 (p <0.001).
- 多变量分析证实菌株组与结果独立相关 (p = 0.014),即使经过对临床因素进行调整.
- 对确定的和边际ARVC病例的次分析显示,菌株组独立预测了终点 (p = 0.023).
结论:
- 双管菌株分析为ARVC患者提供了有价值的预后信息.
- 在RV和LV中受损菌株的患者表现出最糟糕的临床结果.
- 压力成像可以提高风险分层,超出目前的ARVC诊断标准.
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