超声心动图研究左心房应变参数与常规左心房参数对亚洲肥厚性心肌病患者不良预后的预测意义。

IF 2.4 4区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Andre Seah, Tony Y W Li, Novi Yanti Sari, Chi-Hang Lee, Tiong-Cheng Yeo, James W L Yip, Yoke Ching Lim, Kian-Keong Poh, William K F Kong, Weiqin Lin, Ching-Hui Sia, Raymond C C Wong
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引用次数: 0

摘要

背景/目的:左心房功能可以作为肥厚性心肌病(HCM)危险分层的工具。在过去的十年中,人们越来越关注应用应变分析来更早、更准确地预测心血管疾病的预后。本研究旨在探讨左心房应变分析与传统左心房测量在预测亚洲HCM患者临床结局方面的表现。方法和结果:这是一项回顾性研究,涉及2010年至2017年期间诊断为HCM的291例患者。在舒张末期和收缩期末期,采用圆盘正交法评估左心房容积。左心房(LA)菌株采用TOMTEC软件进行事后分析。我们测试了各种左心房参数与(1)心力衰竭住院和(2)不良事件复合无事件生存的结果,包括全因死亡率,室性心动过速(VT)/心室颤动(VF)事件,如果植入了植入式心律转复除颤器(ICD),适当的设备治疗,中风和心力衰竭住院。患者平均年龄59.0±16.7岁,男性居多(71.2%)。在3.9±2.7年的随访中,LA株异常患者的累积无事件生存率为55.2%,而无LA株异常患者的累积无事件生存率为82.4% (p < 0.001)。分别对每个LA参数进行多变量Cox回归分析,调整年龄、性别、左室质量指数、左室射血分数(EF)、E/ E′、静息时左室流出道(LVOT)梗阻和心房颤动。分析表明,除LAEF外,所有参数均与心力衰竭住院有独立关联。左心房应变优于其他参数通过证明与复合不良事件的关联。结论:在亚洲HCM患者中,左心房应变的测量与心力衰竭住院和一系列不良结局独立相关。左心房应变可作为预测HCM患者不良结局的工具。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Prognostic Implication of Left Atrial Strain Parameters with Conventional Left Atrial Parameters for the Prediction of Adverse Outcomes in Asian Patients with Hypertrophic Cardiomyopathy-An Echocardiographic Study.

Background/objectives: Left atrial function can be a tool for risk stratification for hypertrophic cardiomyopathy (HCM). Over the past decade, there has been growing interest in the application of strain analysis for earlier and more accurate prediction of cardiovascular disease prognosis. This study aimed to investigate the performance of left atrial strain analysis compared to conventional left atrial measures in predicting clinical outcomes in Asian patients with HCM.

Methods and results: This was a retrospective study involving 291 patients diagnosed with HCM between 2010 and 2017. Left atrial volumes were assessed using the method of discs in orthogonal plans at both end diastole and end systole. Left atrial (LA) strain was obtained using a post-hoc analysis with TOMTEC software. We tested the various left atrial parameters against outcomes of (1) heart failure hospitalization and (2) event-free survival from a composite of adverse events, including all-cause mortality, ventricular tachycardia (VT)/ventricular fibrillation (VF) events, appropriate device therapy if an implantable cardioverter defibrillator (ICD) was implanted, stroke, and heart failure hospitalization. The patients had a mean age of 59.0 ± 16.7 years with a male preponderance (71.2%). The cumulative event-free survival over a follow-up of 3.9 ± 2.7 years was 55.2% for patients with an abnormal LA strain versus 82.4% for patients without one (p < 0.001). Multivariable Cox regression analyses were performed separately for each LA parameter, adjusting for age, sex, LV mass index, LV ejection fraction (EF), E/e', the presence of LV outflow tract (LVOT) obstruction at rest, and atrial fibrillation. An analysis showed that all parameters except for LAEF demonstrated an independent association with heart failure hospitalization. Left atrial strain outperformed the rest of the parameters by demonstrating an association with a composite of adverse events.

Conclusions: In Asian patients with HCM, measures of left atrial strain were independently associated with heart failure hospitalization and a composite of adverse outcomes. Left atrial strain may be used as a tool to predict adverse outcomes in patients with HCM.

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来源期刊
Journal of Cardiovascular Development and Disease
Journal of Cardiovascular Development and Disease CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
2.60
自引率
12.50%
发文量
381
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