将左心室水库菌株纳入对透析功能的一线评估:在一个具有正常左心室缩功能的社区群体中的预后影响
Máté Tolvaj1, Fjolla Zhubi Bakija2, Alexandra Fábián1
1Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
概括
左心室储应变 (LASr) 改善了在左心室功能正常的患者中检测透功能障碍 (DD) 和风险分层. 在心声图算法中用 LASr 取代 LA 体积指数 (LAVi) 提高了心力衰竭住院和死亡率的预后准确性.
科学领域:
- 心脏病学 心脏病学
- 心声回声图 (Echocardiography) 是一种心声回声图.
- 扩张性功能障碍 扩张性功能障碍 扩张性功能障碍
背景情况:
- 左心房储压力 (LASr) 是左心房 (LA) 功能和升高的填充压力的敏感标志物.
- 它在诊断腹功能障碍 (DD) 和风险分层方面的作用尚未得到充分研究.
- 目前用于DD诊断的算法主要依赖于左心房体积指数 (LAVi).
研究的目的:
- 在2016年美国心声学会/欧洲心血管成像协会 (ASE/EACVI) 的DD诊断算法中,以LASr取代LAVi的预后影响进行评估.
- 将这种修改后的算法与2024年英国心声学会 (BSE) 的算法进行比较.
- 评估左心室 (LV) 缩功能正常的个体的风险分层.
主要方法:
- 从以人口为基础的查中对1180名具有正常LV缩功能的志愿者进行了回顾性分析.
- 心声学评估包括透析功能参数和通过斑点跟踪的LASr.
- 使用BSE算法和修改后的ASE/EACVI算法 (LASr <23%取代LAVi>34mL/m2) 评估透缩功能.
主要成果:
- 在11年内,133名参与者达到主要终点 (全因死亡率或心力衰竭住院治疗).
- 牛脊髓灰质炎算法显示,正常和受损的透析功能组之间没有显著的风险差异.
- 修改后的ASE/EACVI算法确定了三个不同的风险组,在多变量分析中,DD患者的风险显著更高 (调整后的危险比率=3.199).
结论:
- 将LASr整合到扩张功能初始回声心脏学评估中可以改善分类.
- 这种方法提高了以后的风险分层在社区为基础的队列维护LV功能.
- 与LAVi相比,LASr在扩张功能障碍评估方面提供了更好的预后价值.
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