主动脉瓣狭窄患者左心室整体功能指数的预测价值

A. Kapustina, L. Minushkina, M. Alekhin, T. A. Tipteva, V. I. Safaryan, O. S. Chumakova, D. Zateyshchikov
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A total of 377 patients were included to the study, the average age was 79 (75–84) years; 128 (34%) of them were male; 70 patients (19%) had mild aortic stenosis, 116 patients (31%) moderate aortic stenosis, and 191 patients (50%) severe aortic stenosis. LVGFI was calculated as the percentage ratio of LV stroke volume to LV global volume, where LV global volume was defined as the sum of the LV mean cavity volume [(LV end-diastolic volume + LV end-systolic volume)/2] and the myocardium volume. LV myocardial volume was calculated as the ratio of LV myocardial mass to LV density (defined as 1.05 g/mL). The average follow-up period at the moment of analysis was 602.7 ± 48.72 days. All cases of death during the period of follow up were captured.Results. The significant differences of LVGFI obtained between surviving and deceased patients (15.39% (11.35–20.95%) and 20.12% (15.16–25.98%), respectively, p < 0.001). 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摘要

有许多因素会影响主动脉瓣狭窄患者的生存预后。其中一个因素是左心室收缩功能。左心室整体功能指数(LVGFI)考虑了左心室重塑的各个组成部分:目的:使用超声心动图评估 LVGFI 在不同主动脉瓣狭窄严重程度患者中的预后价值。该研究基于 2010-2016 年的前瞻性观察研究数据,然后对超声心动图获得的 LVGFI 进行回顾性计算和分析。研究共纳入377例患者,平均年龄为79(75-84)岁;其中128例(34%)为男性;70例(19%)为轻度主动脉瓣狭窄,116例(31%)为中度主动脉瓣狭窄,191例(50%)为重度主动脉瓣狭窄。LVGFI 以 LV 搏出量与 LV 总容积的百分比率计算,其中 LV 总容积定义为 LV 平均腔容积 [(LV 舒张末期容积 + LV 收缩末期容积)/2] 与心肌容积之和。左心室心肌容积按左心室心肌质量与左心室密度(定义为 1.05 克/毫升)之比计算。分析时的平均随访时间为 602.7 ± 48.72 天。随访期间的所有死亡病例均被记录在案。存活患者和死亡患者的 LVGFI 存在明显差异(分别为 15.39% (11.35-20.95%) 和 20.12% (15.16-25.98%),P < 0.001)。LVGFI值小于18%与轻度主动脉瓣狭窄、中度和重度主动脉瓣狭窄患者在两年随访期间死于各种原因的风险显著相关。因此,在主动脉瓣狭窄致死组患者中,LVGFI 值明显低于存活组患者。LVGFI值低于18%与任何等级的主动脉瓣狭窄患者因各种原因死亡的风险有关。LVGFI 可用于主动脉瓣狭窄患者的死亡风险分层。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Predictive value of left ventricular global function index in patients with aortic stenosis
A number of factors has an impact on the survival prognosis in aortic stenosis patients. One of these factors is a left ventricular (LV) systolic function. Left ventricular global function index (LVGFI) takes into account the components of LV remodeling: LV volume, LV stroke volume, and LV myocardial volume.Objective: to evaluate the prognostic value of LVGFI in patients with various aortic stenosis severity using echocardiography.Material and methods. The study based on the data of previous prospective observational study from 2010–2016, followed by retrospective calculation and analysis of the LVGFI obtained by echocardiography. A total of 377 patients were included to the study, the average age was 79 (75–84) years; 128 (34%) of them were male; 70 patients (19%) had mild aortic stenosis, 116 patients (31%) moderate aortic stenosis, and 191 patients (50%) severe aortic stenosis. LVGFI was calculated as the percentage ratio of LV stroke volume to LV global volume, where LV global volume was defined as the sum of the LV mean cavity volume [(LV end-diastolic volume + LV end-systolic volume)/2] and the myocardium volume. LV myocardial volume was calculated as the ratio of LV myocardial mass to LV density (defined as 1.05 g/mL). The average follow-up period at the moment of analysis was 602.7 ± 48.72 days. All cases of death during the period of follow up were captured.Results. The significant differences of LVGFI obtained between surviving and deceased patients (15.39% (11.35–20.95%) and 20.12% (15.16–25.98%), respectively, p < 0.001). Values of LVGFI < 18% significantly associated with the risk of death from all causes during two years of follow-up in both mild aortic stenosis and moderate and severe aortic stenosis.Conclusion. Thus, in patients with aortic stenosis in the group of fatal outcomes the values of the LVGFI were significantly lower than in the group of surviving patients. LVGFI values of less than 18% associated with the risk of death from all causes in any grade of aortic stenosis. LVGFI can be used for mortality risk stratification in patients with aortic stenosis.
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