动脉切换手术二十年后:右心室功能稳定,但运动能力降低
Renée S Joosen1, Marielle C van de Veerdonk2, Anneloes E Bohte3
1Department of Pediatric Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands.
概括
大动脉转移动脉切换手术后的长期随访显示,右心室功能稳定,但运动能力下降. 这凸显了对这些患者的运动表现持续监测的必要性.
科学领域:
- 心脏病学 心脏病学
- 儿童心脏病学 儿童心脏病学
- 遗传性心脏病是一种先天性心脏病.
背景情况:
- 右心室 (RV) 功能和运动能力是在动脉切换手术 (ASO) 后大动脉转移 (TGA) 患者的关键预后指标.
- 对RV尺寸,全球功能和运动能力的纵向评估对于了解ASO后的长期结果至关重要.
- 将TGA患者与没有RV压力过载之间的结果进行比较,可以了解特定的风险因素.
研究的目的:
- 在动脉切换操作 (ASO) 后对大动脉转移 (TGA) 患者进行纵向评估,对右心室 (RV) 维度,全身功能和运动能力进行纵向评估.
- 为了比较TGA患者与没有RV压力过载之间的RV参数和运动能力随时间变化的变化.
- 在ASO后的长期随访期间评估RV尺寸,功能,应变和大动脉根尺寸的稳定性.
主要方法:
- 在2004年至2024年3月期间,对TGA患者进行了两次心血管磁共振 (CMR) 检查后的ASO后的回顾性分析.
- 使用CMR测量心脏体积,功能,应变和血管尺寸.
- 根据RV压力过载对患者进行分类,并对子集中的重复运动测试进行比较.
主要成果:
- 在长期随访期间,RV体积,功能和菌株保持稳定 (ASO后的中位数为21年).
- 在长期随访期间,大动脉根尺寸没有显著的进展.
- 运动能力 (VO2峰值) 在很大一部分患者 (46%的长期随访) 中下降,与峰值心率或慢性指数无关. 在RV压力过载和没有RV压力过载的患者之间没有观察到差异.
结论:
- 在ASO后的大量TGA患者中,长期运动能力受损.
- 在ASO后的长期随访期间,右心室尺寸,全局功能,应变和大动脉根尺寸稳定.
- 运动能力的下降是一个关键问题,需要持续监测和管理策略.
相关概念视频
Mitral Stenosis I: Introduction
1.8K
Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
1.8K
Aortic Regurgitation III: Medical Management
599
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
599
Heart Failure II: Pathophysiology
2.3K
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
2.3K
Cardiomyopathy II: Dilated Cardiomyopathy
802
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
802
Cardiomyopathy V: Interprofessional Care
762
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...
762
Cardiomyopathy VII: Pre and Post Operative Nursing Management
462
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...
462


