左心房在高血压患者的预后作用:功能比结构更重要吗?
Artem Ovchinnikov1,2, Alexandra Potekhina1,3, Anastasiia Filatova1,4
1Laboratory of Myocardial Fibrosis and Heart Failure with Preserved Ejection Fraction, National Medical Research Center of Cardiology Named After Academician E.I. Chazov, Academician Chazov St., 15a, 121552 Moscow, Russia.
Life (Basel, Switzerland)
|September 27, 2025
概括
在心力衰竭的动脉高血压中,降低左心房储压力 (LASr) 预示着更糟糕的结果. 功能性LA评估,特别是LASr,在这些高风险患者中比LAVI等结构性措施更有预后.
科学领域:
- 心脏病学 心脏病学
- 心血管成像 - 心血管成像
- 临床高血压是一种临床高血压.
背景情况:
- 动脉高血压 (AH) 经常导致左心室 (LA) 发生不良的血液动力学变化.
- 结构性与功能性LA异常的预后价值在高风险的AH患者心力衰竭与保存的喷射分数 (HFpEF) 仍然不清楚.
研究的目的:
- 在被诊断为HFpEF的高血压患者中比较结构性和功能性LA指数的预后意义.
主要方法:
- 追溯分析274名高血压患者的AH,HFpEF和鼻节律.
- 主要结局:综合所有原因死亡率和心力衰竭住院治疗.
- 平均随访时间为4.3年.
主要成果:
- 复合终点发生在49%的患者身上.
- 较低功能的LA储菌株 (LASr) 与明显较低的无事件存活率 (p < 0.001) 有关.
- 更高的结构性LA体积指数 (LAVI),LV填充压力 (E/e'比率) 或LV缩 (LV质量指数) 并没有显示出类似的预后意义.
- 降低LASr和心房动是不良结果的独立预测因素.
结论:
- 功能性LA参数LASr在预测AH和HFpEF患者的预后方面似乎比结构性LA参数LAVI更有效.
- 与传统的LV缩和填充压力指数相比,LASr在这个患者队列中提供了更好的预后价值.
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