移植患者心电图和应变图的附加诊断价值

Decis. Sci. Pub Date : 2023-08-25 DOI:10.3390/sci5030034
L. Stefani, Goffredo Orlandi, M. Corsi, Edoardo Falconi, Roberto Palazzo, A. Pellegrino, P. Modesti
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摘要

背景:移植患者是虚弱的个体,可能受到舒张功能障碍的影响,导致运动耐量下降。已有研究报道,在保留射血分数的情况下,某些心电图和超声心动图参数(如p波间期、PQ间期、p波弥散度、Tend-P间期、QTc间期和应变)可以支持舒张功能障碍的诊断。本研究旨在检查特定ECG和变形参数对移植受者的潜在诊断贡献,这些受者有心力衰竭的高风险。材料与方法:33例移植患者(17例肾移植,16例肝移植)采用保留射血分数(HFpEF)对心力衰竭进行评分。此外,根据心电图参数(p波间隔、PQ间隔、p波弥散和Tend-P QTc)和超声心动图变形参数(应变和扭转)对患者进行评估。采用学生t检验进行统计分析。结果:两种评分确定了可能受HFpEF影响的可排除性和不可排除性受试者的不同数量。非排除组心电图参数值(p波、PQ间期、后壁舒张、Tend-P值均p≤0.05)显著升高,4D应变和扭转值显著降低(p < 0.05)。结论:在HFpEF可能影响患者的舒张功能障碍早期,附加心电图和回声应变参数有重要的诊断价值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Additional Diagnostic Value of Electrocardiogram and Strain Patterns in Transplanted Patients
Background: Transplanted patients are frail individuals who may be affected by diastolic dysfunction, leading to a decrease in exercise tolerance. Previous studies have reported that certain ECG and echocardiographic parameters (such as the P-wave interval, PQ interval, P-wave dispersion, Tend-P interval, QTc interval, and strain) can support the diagnosis of diastolic dysfunction when the ejection fraction is preserved. This study aimed to examine the potential diagnostic contribution of specific ECG and deformation parameters in transplanted recipients, who are at a high risk of heart failure. Materials and Methods: A group of 33 transplanted subjects (17 renal and 16 liver) were categorized using two scores for heart failure with preserved ejection fraction (HFpEF). Additionally, they underwent evaluation based on ECG parameters (P-wave interval, PQ interval, Pwave dispersion, and Tend-P QTc) and echocardiographic deformation parameters (strain and twist). The Student’s t-test was used for statistical analysis. Results: The two scores identified different numbers of excludable and not excludable subjects potentially affected by HFpEF. The not excludable group presented ECG parameters with significantly higher values (P-wave, PQ interval, posterior wall diastole, and Tend-P, all with p ≤ 0.05) and significantly lower 4D strain and twist values (p < 0.05) Conclusions: There is evidence for a significant diagnostic contribution of additional ECG and echo strain parameters in an early phase of diastolic dysfunction in subjects potentially affected by HFpEF.
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