右心室功能与心脏手术后的结果的关联:系统性审查
Neeki Alavi1,2, Wilton Van Klei1,2,3,4,5,6, Kwame Agyei5
1Department of Anesthesia and Pain Management, Sinai Health System, Women's College Hospital, University Health Network, Toronto, ON, Canada.
Canadian journal of anaesthesia = Journal canadien d'anesthesie
|February 12, 2025
概括
对右心室 (RV) 功能的心声测量,如TAPSE和应变,预测心脏手术后的死亡率. RV MPI是主要不良心脏事件 (MACE) 的一致预测指标.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
背景情况:
- 右心室 (RV) 功能评估在心脏外科手术中至关重要.
- 手术后RV功能参数的预后影响尚未完全理解.
- 本系统性审查侧重于心脏手术患者的定量RV功能.
研究的目的:
- 系统地审查RV功能的定量回声心脏学参数.
- 评估它们与心脏手术患者的术后结果的关联.
主要方法:
- 对RCT和观察性研究 (1990-2024) 的系统审查.
- 包括接受心脏手术的成年患者与心声图.
- 主要结局:术后死亡率 (长达5年) 和MACE.
主要成果:
- 包括27项观察性研究;没有发现RCT.
- RV部分面积变化 (RVFAC) 有不一致的关联.
- 三状环状平面缩外流 (TAPSE) 和菌株一致预测死亡率.
- RV心肌性能指数 (MPI) 是MACE的最一致的预测指标.
结论:
- 使用多个心声学参数进行术前和术后的RV功能评估提供了预后价值.
- 经常研究RVFAC,TAPSE,菌株和RV MPI.
- 需要进一步的研究来澄清VR量化在术后预后中的作用.
相关概念视频
01:29Cardiomyopathy V: Interprofessional Care
Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...