在急性心力衰竭中与保留或轻微减少的喷射分数的右心室脱离:一个简单的参数来预测长期死亡率
Lucrecia M Burgos1, Lucía Campos Cervera2, María A De Bortoli1
1Heart failure, pulmonary hypertension and heart transplant department. Instituto Cardiovascular de Buenos Aires. Buenos Aires, Argentina. Heart failure, pulmonary hypertension and heart transplant department Instituto Cardiovascular de Buenos Aires Buenos Aires Argentina.
概括
右心室-肺动脉脱,以低TAPSE/sPAP比率表示,预测了急性心力衰竭患者的长期死亡率,这些患者的喷射分数保持或略有减少. 这一发现有助于识别高风险个体,以便进行更密切的监测.
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.
- 心脏衰竭研究研究
背景情况:
- 急性心力衰竭 (AHF) 风险预测模型正在发展.
- 右心室 (RV) 到肺动脉 (PA) 的脱越来越被认为是不良结果的重要预测因素.
- 在心力衰竭中RV-PA脱的预后价值与保存的 (HFpEF) 和轻微减少的射出分数 (HFmrEF) 需要进一步定义.
研究的目的:
- 评估RV-PA脱与HFpEF和HFmrEF住院患者的长期死亡率之间的关联.
- 为了确定RV-PA脱是否可以在这个患者群体中识别高风险子组.
主要方法:
- 从2015年至2020年对AHF患者 (LVEF> 40%) 未来注册表的回顾性分析.
- 使用三状环状平面缩外流 (TAPSE) 与缩肺动脉压力 (sPAP) 的比率,量化RV-PA合.
- 长期所有原因的死亡率作为主要结局指标.
主要成果:
- 在465名患者中,361名患者 (77%) 可同时测量TAPSE和sPAP.
- 0.38的TAPSE/sPAP比被确定为风险分层的最佳切断值,41.8%的患者低于这个值.
- 脱离RV-PA (TAPSE/sPAP < 0.38) 独立地与长期死亡率的增加有关 (HR: 2.21; P = 0.005).
结论:
- 通过TAPSE/sPAP比率评估的RV-PA脱,是住院AHF患者具有HFpEF和HFmrEF的长期全因死亡率的独立预测因素.
- 这种心声回声测量可以帮助识别更高风险的患者,指导临床管理和后续策略.
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