在心力衰竭中左心房应变的区分能力与轻微减少的射出分数
Li-Tan Yang1, Kuang-Chien Chiang2, Kang Liu2
1Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Telehealth Center, National Taiwan University Hospital, Taipei, Taiwan.
Journal of the Formosan Medical Association = Taiwan yi zhi
|September 30, 2025
概括
左心房储菌株 (LASr) 在心力衰竭中具有显著的预后价值,患者的喷射率略有降低 (HFmrEF). 低LASr独立预测不良结果,支持其常规临床使用.
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:
- 左心房储应变 (LASr) 在轻度减小喷射率 (HFmrEF) 的心力衰竭中的预后意义尚未得到充分确立.
- HFmrEF代表了心力衰竭频谱中的一个独特的人群,需要特定的预后标志物.
研究的目的:
- 研究LASr在HFmrEF患者中的增量预后价值.
- 为了确定LASr是否可以预测超出传统心声学参数的重大不良心血管事件.
主要方法:
- 对1075名接受综合心声扫描的HFmrEF患者进行了回顾性分析.
- 评估左心室 (LV) 和左心房 (LA) 体积,LVEF,E/e',LA体积指数 (LAVi),LV全球纵向应变 (LVGLS) 和LASr使用二维斑点跟踪.
- 主要终点:复合HF再住院 (hHF) 和心血管死亡 (CVD).
主要成果:
- 尽管对临床变量,E/e,LAVi或LVGLS进行了调整,但LASr与hHF和CVD独立相关 (aHR:0.91,P<0.001).
- 在嵌套的考克斯模型中,LASr提供了增量预测值.
- 对于高高温和心血管疾病的风险增加,确定了<18%的LASr值,具有高特异性和≥18%的无事件预测的积极预测值.
结论:
- 在HFmrEF患者中,LASr是不良结果的强有力的独立预测器.
- 与传统回声心脏指数和LVGLS相比,LASr显示出更好的预后性能.
- 建议将LASr整合到常规HFmrEF评估中,等待未来的验证.
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