读书报告RegurgitantVol

RegurgitantVolumeInformsRateofProgressiveCardiacDysfunctioninAsymptomaticPatientsWithChronicAorticorMitralRegurgitationKenyaKusunose,MD,PHD,PaulC.Cremer,MD,RayjiS.Tsutsui,MD,RichardA.Grimm,DO,JamesD.Thomas,MD,BrianP.Griffin,MD,ZoranB.Popovic,MD,PHD

JAmCollCardiolImg;8:14–23.

中度主动脉瓣或二尖瓣返流患者的返流量可预测无症状患者的心功能

报告人：王月丽

时间：.12.17，下午4:00—5：00

地点：病房楼三层超声科示教室

Abstract

OBJECTIVESThisstudyhypothesizedthatregurgitationseverity,asdeterminedbyusingtheregurgitantvolumeindex,wouldbetterdelineatedifferentialcardiacdysfunctioninasymptomaticpatientswithmoderatetosevereaorticregurgitation(AR)andmitralregurgitation(MR).

BACKGROUNDFrequentsurveillanceechocardiographyisconsideredappropriateinasymptomaticpatientswithmoderatetosevereARandMR.However,theevidencetosupportthispracticeandtodefinetheappropriatefrequencyislimited.

METHODSThiswasanobservationalcohortstudyofconsecutivepatientswithmoderatetosevereasymptomaticARorMRwhounderwentexerciseechocardiography.OurcohortincludedpatientswithmoderatetosevereasymptomaticMRandpatientswithmoderatetosevereasymptomaticARwhowerematchedaccordingtoageandregurgitantvolumeindex.Allpatientsunderwentyearlyechocardiographicfollow-upstudies.Regurgitationseveritywasdetermined

accordingtoregurgitantvolumeindex,withalevel≥30ml/m2consideredamarkerofsevereregurgitation.

RESULTSDuringfollow-up,regardlessofetiology,patientswithsevereregurgitationdemonstratedincreasingleftventricularvolumeindexes(4.2±1.5ml/m2peryear;p=0.01)anddecreasingleftventricularejectionfractions(1.3±0.4%peryear;p=0.).Inpatientswithmoderateregurgitation,leftventricularvolumesandejectionfractionsdidnotsignificantlychange.Inaddition,patientswithsevereregurgitationexperiencedasimilardropincontractility(end-systolicpressure/end-systolicvolumeratioandsingle-beatpre-loadrecruitablestrokework)duringfollow-upindependentofregurgitationetiology.Contractilityparametersdidnotchangeinpatientswithmoderateregurgitation.

CONCLUSIONSTheseasymptomaticpatientswithmoderateARorMRhadstablecardiacfunctionduring3yearsoffollow-up;thus,frequentechocardiographywithoutachangeinclinicalstatusmaynotbenecessary.Inthesettingofsevereregurgitation,furthercardiacdeteriorationoccurredatasimilarrateandmannerirrespectiveofwhetherthedysfunctionwasrelatedtoARorMR.

中度主动脉瓣或二尖瓣返流患者的返流量可预测无症状患者的心功能

摘要

目的：本研究在以返流量指数定义返流程度的前提下，假设在无症状的中度至重度主动脉瓣反流（AR）和二尖瓣反流（MR）患者中，以返流的严重程度将更好预测此类患者的心功能

背景：以往认为在无症状的中度至重度主动脉瓣返流（AR）和二尖瓣返流（MR）患者中频繁的超声心动图检测是适当的。然而，却缺乏足够的证据支持这一做法和规定检查频率。

方法：此项观察性队列研究共纳入例无症状中重度MR患者和例无症状中重度AR缓和，并依据年龄和返流量指数对其加以配对。利用定量多普勒确定返流严重度，并以返流量指数≥30ml/m2定义重度返流。所有患者均接受年度超声心动图随访。

结果：随访期间无论病因如何，重度返流患者均表现为左室容积指数升高和射血分数降低。在中度返流患者中，左室容积和射血分数则无显著变化。重度返流患者在随访期间出现相似的收缩性降低，并且独立于返流病因。在中度返流患者中收缩性参数未出现显著变化。

结论：该研究结果显示随访3年时，对于无症状的主动脉瓣/二尖瓣返流患者，中度患者心脏功能可稳定3年，重度患者心脏功能会较差。

本读书报告全文总结期的中英文近将在“超声掌中宝·心动版”中播放，敬请







































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