使用计算机断层扫描的新测量预测了左前庭尾关闭的成功
Ryo Yamaguchi1, Masanori Yamamoto1,2,3, Mitsuru Sago1
1Department of Cardiology, Toyohashi Heart Center, Toyohashi, Japan.
概括
一个新的基于CT的比率 (Rcal) 能够有效地预测左心房尾关闭 (LAAC) 的程序成功. 这一指标改善了患者选择和计划Watchman FLX设备植入的情况.
科学领域:
- 心血管成像 - 心血管成像
- 干预心脏病学 干预心脏病学
- 医疗器械技术 医疗器械技术
背景情况:
- 过食管回声心电图 (TEE) 和计算机断层扫描 (CT) 是在左心房附属物关闭 (LAAC) 中的程序前查的标准.
- 对于LAAC来说,准确预测程序性设备成功 (DS) 仍然是当前方法的挑战.
研究的目的:
- 评估一种基于CT的新型评估,用于预测LAAC的DS.
- 为了确定CT衍生的比率,考虑着陆区和内部隔膜,改善DS预测.
主要方法:
- 来自日本注册机构的560名用Watchman FLX进行LAAC的患者的分析.
- 程序前CT测量包括LAA着陆区直径 (Dland),LAA长度 (L) 和大叶骨直径 (Dlobe).
- 计算了一种新型比率 (Rcal = L/(Dland-Dlobe)) 并通过ROC分析评估其预测性能.
主要成果:
- 设备成功 (DS) 在95.5%的患者中实现.
- 与成功组 (1.00 ± 0.28) 相比,设备故障组 (0.66 ± 0.25) 的Rcal显著较低.
- 与传统CT (AUC:0.552) 和TEE (AUC:0.456) 衍生比率相比,Rcal显示出更好的预测性能 (AUC:0.872).
结论:
- 新的CT衍生度量Rcal准确地预测了Watchman FLX植入器件的设备成功.
- Rcal对LAA着陆区尺寸和内部七度进行了计算,提供了改进的预测能力.
- 这一指标可以提高LAAC前的患者选择和程序规划.
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