术前的大脑体积损失与晚期心力衰竭患者的术后妄想有关,这些患者由左心室辅助装置支持
Iván Murrieta-Álvarez1, Jacob P Scioscia1, José M Benítez-Salazar2
1Michael E. DeBakey Department of Surgery, Division of Cardiothoracic Transplantation and Circulatory Support, Baylor College of Medicine, Houston, TX, USA.
Scientific reports
|March 15, 2025
概括
手术前的大脑缩,特别是侧心室扩大,预测左心室辅助器件 (LVAD) 植入后心脏衰竭患者的 Delirium. 这一发现有助于识别有风险的个体,以获得更好的术后护理.
科学领域:
- 神经学 神经学
- 心脏病学 心脏病学
- 放射学 放射学是一门学科.
背景情况:
- 痴呆症是左心室辅助器件 (LVAD) 植入后在高级心力衰竭 (ADHF) 患者中经常出现的神经并发症.
- 手术后妄想会对患者的康复和结果产生负面影响.
研究的目的:
- 调查通过非对比CT扫描评估的先前存在的大脑缩和在接受LVAD植入的ADHF患者中术后妄想的发生率之间的联系.
- 为了确定特定的神经成像标记,预测妄想的发展.
主要方法:
- 包括166名ADHF患者的队列,这些患者在2020年3月至2023年7月期间接受了LVAD植入.
- 使用定量神经成像技术分析了手术前的非对比CT扫描,重点关注侧腔室分量 (LVF) 和其他体积测量 (cGMF,WMF,BGF,TLF).
主要成果:
- 在166名患者中,56名 (33%) 在植入后两周内发病了妄想.
- 痴呆症患者年龄较大,大脑缩显著增加 (LVF高,cGMF低,WMF,BGF,TLF).
- 较高的LVF是 Delirium 的强有力的预测因素,不依赖年龄.
结论:
- 手术前的大脑体积分析,特别是LVF,对于识别患有ADHF患者在LVAD后患上术后狂妄症的高风险至关重要.
- 早期识别可以指导增强的术后管理策略,潜在地改善LVAD接受者的结果.
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