斑点跟踪成像在埃布斯坦异常风险分层中的作用
Daniella Haas1, Meena Bai1, Sara Aboelmaaty1
1Mayo Medical School, Mayo Clinic Rochester, Rochester, MN, 55905, USA.
在埃布斯坦异常患者中,左心室全球纵向应变 (LVGLS) 提供了比左心室射出分数 (LVEF) 更好的风险评估. 低LVGLS预测生存率降低,无论LVEF,指导治疗决策.
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.
- 遗传性心脏病是一种先天性心脏病.
背景情况:
- 左心室喷射分数 (LVEF) 的有效性受到LV几何和负载条件等因素的限制.
- 左心室全球纵向菌株 (LVGLS) 对这些因素不那么敏感,并且在获得的心脏病中显示出更好的预后表现.
- 与LVEF相比,LVGLS可能与心力衰竭指数和无移植生存率有更好的相关性.
研究的目的:
- 调查LVGLS和LVEF与心力衰竭指数的相关性.
- 为了比较LVGLS和LVEF在患有埃布斯坦异常的患者的预后性能.
- 确定LVGLS对无移植生存的预测值.
主要方法:
- 追溯的队列研究.
- 包括从2003年到2018年673名患有埃布斯坦异常的成年患者.
- 分析了LVGLS,LVEF,心脏指数,淋巴膜过率和NT-proBNP之间的相关性.
主要成果:
- 与LVEF相比,LVGLS与心脏指数 (r=0.46对r=0.21),GFR (r=0.57对r=0.19) 和NT-proBNP (r=-0.64对r=-0.41) 的相关性更强.
- 患者被分为正常的LV系统功能 (76%),亚临床LV功能障碍 (13%),和明显的LV功能障碍 (10%).
- 低LVGLS是无移植生存的独立预测因子,无论LVEF,并且与心力衰竭治疗开始减少有关.
结论:
- 在埃布斯坦异常中,LVGLS提供了比LVEF更强大的风险分层和预测.
- 患有低LVGLS的患者,无论LVEF如何,都减少了无移植存活率.
- LVGLS是指导这一群体医学和外科治疗决策的临床重要指标.
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