双心室压力-体积面积比,用于评估左心室对双开关操作的准备度
Nikhil Thatte1, Peter E Hammer2, Gerald Marx1
1Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts, USA; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA.
JACC. Advances
|February 25, 2026
概括
评估左心室 (LV) 对双开关操作 (DSO) 的准备是至关重要的. 一个新的估计LV:RV压力-体积面积 (PVA) 比率≥0.67可靠地预测了先天纠正大动脉转移的患者的成功结果.
科学领域:
- 心脏病学 心脏病学
- 儿科心脏手术 儿科心脏手术
- 医疗工程 医学工程
背景情况:
- 评估左心室 (LV) 准备双开关操作 (DSO) 在先天纠正的大动脉转移 (cc-TGA) 与完整的心室隔膜是具有挑战性的.
- 肺下 LV 压力-体积区域 (PVA) 作为心室工作负载和充足性评估的关键指标.
研究的目的:
- 为了确定LV-PVA是否可以从标准临床参数可靠地估计 (ePVA).
- 调查LV:RV ePVA比率与DSO后结果之间的关联.
主要方法:
- 用导电导管测量LV-PVA,并与从导管和体积数据计算的ePVA进行比较.
- 使用皮尔森相关性和布兰德-阿尔特曼分析来评估协议和偏见.
- 一个回顾性队列评估了复合不良结果与LV:RV ePVA比率之间的关联,使用单变Cox比例危险模型.
主要成果:
- 与测量的PVA相比,ePVA显示了高一致性和低偏差.
- 在一个由42名患者组成的队列中,有14%的患者经历了不良结果.
- 较低的LV:RV ePVA比率 (<0.67) 与LV质量指数不同,与DSO后不良结果 (HR:3.9) 有显著的关联.
结论:
- 使用非侵入性数据估计肺下LV-PVA是可靠的.
- 在cc-TGA患者中,≥0.67的LV:RVePVA比率是对cc-TGA患者对DSO的LV准备的有希望的区分因子.
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