在Fontan型血液循环患者中具有独特的血液动力学表型,患有远端食道静脉
Luis Téllez1, María Toledano2, María Álvarez2
1Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, IRYCIS, CIBERehd, Universidad de Alcalá, Madrid, Spain.
Hepatology (Baltimore, Md.)
|July 22, 2025
概括
远端食道静脉 (EV) 在Fontan循环患者中很常见,与高血压和严重的肝纤维化有关. 这种独特的血液动力学特征需要对患有丰坦型血液循环的成年人进行仔细监测.
科学领域:
- 心脏病学 心脏病学
- 肝病学 肝病学是一种肝病学.
- 胃肠病学 胃肠病学
背景情况:
- 食道静脉 (EV) 是一个已知的并发症在成年人与Fontan-类型的循环.
- 导致EV的血液动力学机制可以根据它们的解剖位置不同.
研究的目的:
- 为了确定食道静脉的患病率和解剖分布,在成年人与Fontan类型的循环.
- 在这个患者群体中识别与食道变节相关的血液动力学因素.
主要方法:
- 在114名患有Fontan型血液循环的成年人中进行前性队列研究.
- 进行了结合性肝脏和心脏导管,食管胃管腺镜和肝脏活检.
- 患者根据EV的存在和位置 (近端或远端) 进行分类.
主要成果:
- 食道静脉 (EV) 在36.8%的患者中存在,其中28.9%的患者患有远端静脉和17.5%的患者患有近端静脉.
- 远程EV与较高的心脏指数,高血压和较低的全身血管阻力相关 (p <0.01).
- 严重的肝纤维化在远端EV患者 (87.9%) 与其他组相比明显更常见 (p <0.05).
结论:
- 远端食道静脉在Fontan循环中很常见,并定义了一个特定的血液动力学表型.
- 这种表型包括Fontan通路压力升高,门高血压和高动态循环状态.
- 在远端EV患者中观察到高的非侵入性纤维化标志物,表明严重的肝病.
相关概念视频
Esophageal Varices-I: Introduction
345
Esophageal varices are dilated, tortuous veins which are found mainly in the submucosa of the lower esophagus but which may also appear higher up or extend into the stomach. They develop due to increased pressure in the portal venous system, often as a result of liver cirrhosis. This condition scars and damages the liver, impeding normal blood flow through the portal vein. To compensate, blood seeks alternative pathways, forming fragile new vessels (varices) in the esophagus and stomach. These...
345
Esophageal Varices-II: Clinical Features and Management
145
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
145
Aortic Regurgitation II: Clinical Features and Diagnostic Tests
59
Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
59
Cardiomyopathy III: Hypertrophic Cardiomyopathy
52
Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
52


