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首页> 外文期刊>The American Journal of Cardiology >Usefulness of Left Atrial Reservoir Size and Left Ventricular Untwisting Rate for Predicting Outcome in Primary Mitral Regurgitation
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Usefulness of Left Atrial Reservoir Size and Left Ventricular Untwisting Rate for Predicting Outcome in Primary Mitral Regurgitation

机译：左心房储液大小和左心室扭转率对预测原发性二尖瓣反流的疗效。

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The present study proposed to evaluate whether analysis of cardiac mechanics through speckle-tracking imaging is useful for risk stratification in asymptomatic patients with chronic primary mitral regurgitation (MR). We prospectively enrolled 67 patients (mean age 57 +/- 18 years) and followed them over time. MR was mild in 20 patients (30%), moderate in 24 (36%), and severe in 23 (34%). After a mean time of 24.8 +/- 17 months, 34 patients (51%) remained asymptomatic, whereas 33 (49%) developed events (19 underwent mitral valve surgery, 9 required hospitalization for acute heart failure, and 5 patients died). Compared to asymptomatic patients, those with events at baseline showed more severe MR, larger and spherical ventricles, diastolic. dysfunction, and greater systolic pulmonary arterial pressure. Moreover, patients with events had decreased left atrial (LA) reservoir (p <0.001) and left ventricular (LV) untwisting rate (p <0.001). On univariate Cox regression analysis, effective regurgitant orifice area (p <0.001), vena contracta (p <0.001), systolic pulmonary arterial pressure (p = 0.003), LV end-systolic diameter (p <0.001), E/E' ratio (p = 0.004), LA volume (p = 0.001), LA reservoir (p <0.001), and LV untwisting rate (p <0.001) were associated with an increased risk of events. On multivariate analysis, only LA reservoir (p = 0.013) and LV untwisting rate were independent predictors (p = 0.017) of outcome. Moreover, LA reservoir evaluation significantly improved (p = 0.013) risk stratification compared to recommended parameters.. In conclusion, impaired cardiac mechanics is more closely associated than severity of MR with the occurrence of events in asymptomatic chronic primary MR. (C) 2015 Elsevier Inc. All rights reserved.
机译：本研究旨在评估通过斑点追踪成像对心脏力学进行分析是否可用于无症状的慢性原发性二尖瓣关闭不全患者的危险分层。我们前瞻性招募了67名患者（平均年龄57 +/- 18岁），并随时间推移对其进行随访。 MR为轻度20例（30％），中度24例（36％），重度23例（34％）。在平均时间24.8 +/- 17个月后，有34例患者（51％）保持无症状，而33例（49％）发生了事件（19例行二尖瓣手术，9例因急性心力衰竭住院，5例死亡）。与无症状的患者相比，那些基线事件的患者表现出更严重的MR，较大的球形心室，舒张期。功能障碍，以及收缩期肺动脉压增高。此外，有事件的患者左心房（LA）储血量减少（p <0.001）和左心室（LV）的不扭曲率（p <0.001）。单因素Cox回归分析，有效的反流孔面积（p <0.001），腔静脉收缩（p <0.001），收缩期肺动脉压（p = 0.003），LV收缩末期直径（p <0.001），E / E'比（p = 0.004），洛杉矶体积（p = 0.001），洛杉矶水库（p <0.001）和左心室扭转率（p <0.001）与事件风险增加相关。在多变量分析中，只有LA储层（p = 0.013）和LV解捻率是结果的独立预测因子（p = 0.017）。此外，与推荐参数相比，LA储库评估显着改善了风险分层（p = 0.013）。总而言之，与无症状的慢性原发性MR事件发生相比，心脏力学受损比MR严重程度更紧密相关。 （C）2015 Elsevier Inc.保留所有权利。

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