减少左心房顺应性加剧了肺移植后的初级移植功能障碍
Michal Schäfer1, Craig H Selzman1, Laura DiChiacchio2
1Division of Cardiothoracic Surgery, University of Utah, Salt Lake City, Utah.
概括
在肺移植 (LTx) 之前减少左心房应变 (LAS) 预测初级移植功能障碍 (PGD). 这一发现强调了LAS作为评估LTx受体PGD风险的关键生物标志物.
科学领域:
- 心脏病学 心脏病学
- 胸部外科手术 胸部外科手术
- 移植医学 移植医学
背景情况:
- 主要移植功能障碍 (PGD) 显著影响肺移植 (LTx) 的结果.
- 在接受者中,先前存在的左心室扩张功能障碍会增加PGD风险.
- 左心房应变 (LAS) 是左心房合规性的敏感标志物.
研究的目的:
- 调查双边肺移植 (LTx) 后PGD手术前左心房应变 (LAS) 的预测作用.
- 评估LAS作为PGD风险分层的潜在生物标志物.
主要方法:
- 在132名LTx患者中,对LAS (水库,导管,) 和左心室全球纵向应变 (LV GLS) 的术前心声图分析.
- 菌株指数与PGD 3级发生的相关性 (定义为P:F <200在48/72小时).
- 单变量和多变量分析,包括右心导管数据,以确定PGD预测因子.
主要成果:
- 在PGD (+) 和PGD (-) 组之间,传统的左心室扩张性功能障碍标志物没有显著差异.
- 患有PGD的患者表现出储LAS,导管LAS和LV GLS的减少.
- 多变量分析确定了减少导管LAS和增加的肺血管抵抗作为PGD的独立预测因素.
结论:
- 术前左心室顺应性降低,以减少的 LAS 表示,与 LTx 接受者具有正常 LV 功能的 PGD 风险更高有关.
- 在未来的前性研究中,LAS应被视为PGD的一个有价值的风险因素.
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