全球纵向菌株作为儿科扩展性心肌病中左心室功能障碍的敏感标记:一个案例对照研究
Iolanda Muntean1,2, Beatrix-Jullia Hack2, Asmaa Carla Hagau2,3,4
1Department of Paediatrics III, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, 540136 Targu Mures, Romania.
Journal of cardiovascular development and disease
|September 26, 2025
概括
斑点跟踪回声心脏图显示,扩张性心肌病 (DCM) 的儿童的全球纵向应变 (GLS) 和应变率 (SR) 降低,表明左心室 (LV) 功能障碍显著. GLS是评估儿科DCM疾病严重程度和风险分层的临床相关标志物.
科学领域:
- 心脏病学 心脏病学
- 儿童心脏病学 儿童心脏病学
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
背景情况:
- 儿科扩张性心肌病 (DCM) 是儿童心力衰竭 (HF) 的罕见原因,通常需要心脏移植.
- 早期发现亚临床心肌功能障碍对于在儿科DCM中有效地分层和管理风险至关重要.
- 传统的心声回声学参数可能无法完全捕捉左心室 (LV) 缩功能中的微妙障碍.
研究的目的:
- 评估DCM儿童的左心室 (LV) 缩功能,使用常规心声学和斑点跟踪心声学 (STE).
- 探索由STE衍生的变形指数 (GLS,SR) 和临床严重性标志物 (包括NT-proBNP) 之间的关系.
- 评估GLS和其他心声回声学参数在儿科DCM的诊断和预后价值.
主要方法:
- 一项涉及29名DCM儿童和27名健康对照者的病例控制研究,根据年龄和性别进行了匹配.
- 所有参与者都接受了临床评估,NT-proBNP测量和跨胸腔心声扫描.
- 使用常规参数和STE评估LV缩功能,以从顶点视图测量LV全球纵向应变 (GLS) 和应变率 (SR).
主要成果:
- 与健康对照组相比,患有DCM的儿童在所有尖端视图中显著减少了GLS和SR (p < 0.01).
- GLS与功能指数 (LVEF,LVSF),LV终端-透气直径Z-分数和NT-proBNP (p <0.05) 强烈相关.
- 接收器操作特征 (ROC) 分析表明,在确定DCM严重性的过程中,NT-proBNP (AUC 0.948) 和GLS (AUC 0.906) 的区别非常好.
结论:
- 来自斑点跟踪的GLS和SR是儿科DCM中LV功能障碍的敏感和临床相关标志物.
- 全球纵向菌株 (GLS) 与儿科DCM疾病严重程度的临床和生化标志物有着强烈的关联.
- 将GLS整合到常规评估中,支持对被诊断为DCM的儿童进行增强的风险分层.
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