针对左心房附属体封闭的心内或食管间心声学:最新的系统性审查和元分析
Eirini Beneki1,2, Kyriakos Dimitriadis3, Panagiotis Theofilis3
1First Cardiology Department, School of Medicine, Hippokration General Hospital, National and Kapodistrian University of Athens, Athens, Greece. e.beneki@hotmail.com.
The international journal of cardiovascular imaging
|January 22, 2025
概括
心内回声学 (ICE) 与输食管回声学 (TEE) 相比,在左心房附属物阻塞 (LAAO) 方面提供了更好的技术成功. 然而,ICE指导与不良事件的风险增加有关,需要仔细考虑.
科学领域:
- 心脏病学 心脏病学
- 医疗成像医学成像
- 干预程序 干预程序
背景情况:
- 穿皮左心房尾闭塞 (LAAO) 是心房动患者中风预防的关键程序.
- 经食道心声学 (TEE) 是LAAO指导的标准成像方式.
- 心内回声心谱 (ICE) 已经成为LAAO的潜在替代成像技术.
研究的目的:
- 为了比较ICE与TEE在指导LAAO程序中的有效性和安全性.
- 评估技术成功率和设备部署在ICE引导与TEE引导的LAAO中.
- 评估LAAO期间与每个成像模式相关的不良事件的发生率.
主要方法:
- 进行了全面的元分析.
- 在MEDLINE,Scopus和Web of Science数据库中进行文献搜索,截至2023年11月.
- 包括18项涉及124230名接受LAAO的患者的研究.
主要成果:
- 与TEE相比,使用ICE指导技术成功率显著高 (OR:1.36,p=0.006).
- 使用ICE指导的设备较少 (SMD: -0.22,p=0.04).
- ICE的指导与心周溢出/栓塞 (logRR:0.62,p<0.001) 的增加率,阳性残留突变 (RR:1.53,p=0.02) 和血管并发症 (logRR:0.45,p=0.009) 的增加率有关.
结论:
- ICE引导成像是LAAO的TEE可行的替代方案,证明了卓越的技术成功.
- 随着ICE的不良事件发生率的增加,需要仔细的临床考虑.
- 可能需要进一步的研究来优化ICE协议并减轻相关风险.
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