右或左心内膜组织活检? 一个系统的审查与对并发症和安全性进行元分析
Henrique Alexsander Ferreira Neves1, Gabriela Yanaze Takamatsu1, Bruna Sadae Yuasa1
1Federal University of Paraná, Curitiba, PR, Brazil.
JHLT open
|March 27, 2025
概括
左心室内心肌活检 (LV-EMB) 比右心室内心肌活检 (RV-EMB) 更安全,心周并发症的发生率显著降低. 此外,LV-EMB对心肌炎和心肌病的诊断效率也很高.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 诊断程序 诊断程序 诊断程序
背景情况:
- 内心肌活检 (EMB) 对于诊断心肌炎和非缺血性心肌病非常重要.
- 左心室 (LV-EMB) 与右心室 (RV-EMB) 内心肌活检的比较安全性仍在争论中.
- 这一元分析涉及LV-EMB与RV-EMB的安全性和结果.
研究的目的:
- 为了比较LV-EMB与RV-EMB在接受内肌心活检的患者中的结果.
- 为了确定LV-EMB是否是一种比RV-EMB更安全的替代方案.
- 为了评估LV-EMB和RV-EMB之间的诊断产量差异.
主要方法:
- 在PubMed,Embase和Cochrane Central进行了系统的文献搜索,直到2023年1月.
- 分析包括了6项涉及6308名患者的研究,比较了主要和轻微并发症.
- 评估的结果包括死亡,浴,输血,中风,心律失常和局部并发症;偏差风险使用ROBINS-I.
主要成果:
- 与RV-EMB相比,接受LV-EMB的患者表现出心周栓塞和/或输出率明显较低 (OR 0.54;95% CI 0.31-0.93;p=0.03).
- 在LV-EMB组中,心周并发症的总体发病率降低.
- 在其他主要并发症方面没有显著差异,但LV-EMB显示心周穿孔的发生率较小.
结论:
- 左心室内心肌活检 (LV-EMB) 与右心室内心肌活检 (RV-EMB) 相比,与心周并发症的风险较低有关.
- LV-EMB显示了肌心炎和其他心肌病的高诊断收益率.
- 这些发现支持LV-EMB作为潜在的更安全和更有效的心脏诊断选择.
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