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首页> 外文期刊>European journal of heart failure: journal of the Working Group on Heart Failure of the European Society of Cardiology >The role of ventricular–arterial coupling in cardiac disease and heart failure: assessment, clinical implications and therapeutic interventions. A consensus document of the European Society of Cardiology Working Group on Aorta & Peripheral Vascular Diseases, European Association of Cardiovascular Imaging, and Heart Failure Association
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The role of ventricular–arterial coupling in cardiac disease and heart failure: assessment, clinical implications and therapeutic interventions. A consensus document of the European Society of Cardiology Working Group on Aorta & Peripheral Vascular Diseases, European Association of Cardiovascular Imaging, and Heart Failure Association

机译:心室动脉偶联在心脏病和心力衰竭中的作用:评估,临床意义和治疗干预措施。 欧洲心电图和外周血血管疾病,欧洲心血管成像和心力衰竭协会的欧洲心脏病学工作组的共识文件

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摘要

Ventricular–arterial coupling (VAC) plays a major role in the physiology of cardiac and aortic mechanics, as well as in the pathophysiology of cardiac disease. VAC assessment possesses independent diagnostic and prognostic value and may be used to refine riskstratification and monitor therapeutic interventions. Traditionally, VAC is assessed by the non‐invasive measurement of the ratio of arterial (Ea) to ventricular end‐systolic elastance (Ees). With disease progression, both Ea and Ees may become abnormal and the Ea/Ees ratio may approximate its normal values. Therefore, the measurement of each component of this ratio or of novel more sensitive markers of myocardial (e.g. global longitudinal strain) and arterial function (e.g. pulse wave velocity) may better characterize VAC. In valvular heart disease, systemic arterial compliance and valvulo–arterial impedance have an established diagnostic and prognostic value and may monitor the effects of valve replacement on vascular and cardiac function. Treatment guided to improve VAC through improvement of both or each one of its components may delay incidence of heart failure and possibly improve prognosis in heart failure. In this consensus document, we describe the pathophysiology, the methods of assessment as well as the clinical implications of VAC in cardiac diseases and heart failure. Finally, we focus on interventions that may improve VAC and thus modify prognosis.
机译:心室动脉偶联(VAC)在心脏和主动脉机械的生理学中起主要作用,以及心脏病的病理生理学。 VAC评估具有独立的诊断和预后价值,可用于改进风险化和监测治疗干预措施。传统上,通过非侵入性测量的动脉(EA)与心室末端收缩量(EES)的非侵入性测量来评估VAC。随着疾病进展,EA和EES都可能变得异常,EA / EES比率可以近似其正常值。因此,测量该比率的每个组分或新颖的心肌(例如全局纵向菌株)和动脉函数(例如脉搏波速度)的新敏感标志物可以更好地表征VAC。在瓣膜心脏病中,全身性动脉符合性和Valvulo-动脉阻抗具有既定的诊断和预后价值,并可能监测瓣膜置换对血管和心脏功能的影响。通过改善其两种组分或其每种组分的改善引导的治疗可能会延迟心力衰竭的发生,并且可能改善心力衰竭的预后。在这一共识文件中,我们描述了病理生理学,评估方法以及VAC中的心脏病和心力衰竭的临床意义。最后,我们专注于可能改善VAC的干预措施,从而改变预后。

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