峰值心肌工作评估检测冠状动脉缺血在多布他胺应激心电回声学期间的冠状动脉缺血
Salima Qamruddin1,2,3, Chen Fang2, Sergey Kachur1,2
1Division of Cardiovascular Disease, John Ochsner Heart and Vascular Institute, New Orleans, LA, United States.
峰值全球心肌工作效率 (GWE) 提高了多布他胺应激心声学 (DSE) 在检测冠状动脉缺血的准确性. 这种增强可以减少不必要的二次测试和相关的医疗保健成本.
科学领域:
- 心脏病学 心脏病学
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
- 心肌机械学 心肌机械学
背景情况:
- 全球心肌工作效率峰值 (GWE) 是建设性心肌工作与浪费心肌工作的比率.
- 在压力心声学期间,GWE已经证明了在识别冠状动脉缺血的潜力.
- 除了全球纵向应变 (GLS) 和全球工作指数 (GWI),GWE的附加值在多布胺应激心声学 (DSE) 中需要进一步研究.
研究的目的:
- 评估高峰GLS,GWI和GWE在改善异常DSE的积极预测值 (PPV) 中的额外诊断实用性.
- 评估通过减少对冠状动脉疾病 (CAD) 进行二次确认测试的需求来实现的潜在成本节约.
主要方法:
- 一项前性研究招募了患有异常DSE的患者,他们进行了二次测试以确认CAD.
- 基线和峰值GLS,GWI和GWE在初级队列和正常DSE的对照组中进行了测量.
- 根据二次测试的费用进行了成本分析.
主要成果:
- 与对照组相比,患有显著CAD的患者表现出明显较低的峰值GLS,GWI,GWE和全球建设性工作 (GCW).
- 接收器运行特征 (ROC) 分析证实GWE在峰值时有能力区分冠状动脉缺血 (AUC 0.76,p=0.01).
- 将高峰GWE值<87%纳入DSE解释,PPV从45%增加到81%,估计每名患者的成本节省为8,274美元.
结论:
- 将峰值GWE纳入DSE解释可以显著提高冠状动脉缺血的诊断准确性.
- 这种方法减少了对昂贵的下游诊断程序的需求.
- 峰值GWE是提高DSE有效性和优化患者管理途径的有价值指标.
更多相关视频
08:21Functional Assessment of the Donor Heart During Ex Situ Perfusion: Insights from Pressure-Volume Loops and Surface Echocardiography
Published on: October 11, 2022
11:50High-frequency High-resolution Echocardiography: First Evidence on Non-invasive Repeated Measure of Myocardial Strain, Contractility, and Mitral Regurgitation in the Ischemia-reperfused Murine Heart
Published on: July 9, 2010
相关概念视频
Exercise Stress Test
Exercise stress testing, commonly known as a treadmill test, is a noninvasive procedure used to evaluate cardiovascular function and diagnose heart conditions.
Definition
An exercise stress test measures the heart's response to exertion using a treadmill or stationary bicycle. Chest electrodes record the heart's electrical activity through an ECG, and blood pressure is monitored regularly.
Purposes
Imaging Studies for Cardiovascular System II:Types of Echocardiography
Types of Echocardiography
Transthoracic Echocardiography (TTE)
TTE is the most common type of echocardiogram which involves placing a transducer on the patient's chest, emitting sound waves to create heart images. TTE is invaluable for evaluating the heart's size, structure, and motion, making it particularly useful for...
Electrocardiogram
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
Imaging Studies for Cardiovascular System I:Echocardiography
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion,...
