右心室功能障碍与血液体积膨胀的关联导致慢性左心衰竭的结果
Wayne L Miller1, Viktoria I Skidan1, Sorin V Pislaru1
1Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, United States.
概括
慢性左侧心力衰竭患者的血液体积膨胀 (BVE) 可能是适应性反应. 尽管右心室功能障碍 (RVD),BVE与更好的结果有关,这表明它补偿了RVD.
科学领域:
- 心脏病学 心脏病学
- 心血管生理学心血管生理学
背景情况:
- 慢性左心衰竭 (HF) 通常涉及右心室功能障碍 (RVD).
- 在患有RVD的HF患者中,同时发生的血液体积膨胀 (BVE) 的作用尚不清楚.
- 评估RVD严重程度,BVE和临床结果之间的关系对于患者管理至关重要.
研究的目的:
- 评估RVD严重程度,BVE和慢性左侧HF患者的临床结果之间的关联.
- 为了确定BVE是否可以预测临床结果,而不依赖于RVD的严重程度.
主要方法:
- 对150名临床evolemic患者在医院出院时进行前性研究.
- 使用核医学指标-稀释测量血液体积 (BV).
- 根据RVD严重程度和BVE (≥+25%的正常体积) 分层的患者.
- 综合结果 (HF死亡率/再住院) 评估在1年后.
主要成果:
- 在出院时观察到RVD (76%) 和BVE (51%) 的高患病率.
- 中度或较大的RVD患者的绝对BV比较大.
- 与正常VR功能 (33%) 相比,BVE在RVD患者中更常见 (59%).
- 带有红细胞血症的BVE独立预测了更好的1年复合结果 (P=0.037).
- 单独的RVD与风险增加无关 (P=0.137).
结论:
- 在慢性左侧HF中,BVE是普遍存在的,并且与更好的结果相关,即使是RVD.
- 单靠RVD并不能预测风险增加,这表明BVE可能是一个补偿机制.
- BVE可能在减轻慢性HF中RVD的负面影响方面发挥适应性作用.
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