Eur Heart J-Card Img:非缺血性扩张型心肌病继发二尖瓣返流修复与左心室逆向重构和前向血流增加有关

2018-02-11 xing.T MedSci原创

由此可见,对于非缺血性扩张型心肌病患者继发性MR进行手术和经导管二尖瓣修复可以改善患者LV前向血流并促进LV逆转重构,但并未改变LV收缩功能。

对于非缺血性心肌病患者继发性二尖瓣返流(MR)接受手术或经导管二尖瓣修复术治疗后是否会逆转左心室(LV)潜在的病理生理机制尚不清楚。近日,心血管领域权威杂志Eur Heart J-Card Img上发表了一篇研究文章,研究人员假设二尖瓣修复术能改善这类人群的LV收缩功能和前向血流,并促进其LV逆转重构。

研究人员对76例非缺血性心肌病伴有中度至重度MR的患者(65±14岁,43%男性)进行评估,并且这些患者接受经导管或手术治疗对二尖瓣进行了成功的修复。研究人员在基线、出院和修复后6个月对受试者进行经胸超声心动图检查。

二尖瓣修复后,校正LV舒张末期容积后,LVEF和LV整体纵向应变(GLS)保持不变(分别有P=0.90和P=0.96)。与正常对照者相比,LV前向血流量显著增加(每搏量指数:20±7-29±8和26±8 mL/m2,P<0.001;心脏指数:1.50±0.44-2.36±0.60和2.01±0.48 L/min/m2,P<0.001)。此外,LV舒张末期和收缩末期容积指数随时间显著降低(87±42-70±33和75±39mL/m2,P<0.001;以及从60±35-50±30和53±36 mL/m2,P=0.004),这些变化与修复类型无关。

由此可见,对于非缺血性扩张型心肌病患者继发性MR进行手术和经导管二尖瓣修复可以改善患者LV前向血流并促进LV逆转重构,但并未改变LV收缩功能。

原始出处:

Vasileios Kamperidis,et al. Mitral valve repair for secondary mitral regurgitation in non-ischaemic dilated cardiomyopathy is associated with left ventricular reverse remodelling and increase of forward flow. Eur Heart J-Card Img. 2018. https://doi.org/10.1093/ehjci/jex011

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    2018-09-04 feifers
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href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Tue Feb 13 05:59:00 CST 2018, time=2018-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1413216, encodeId=4a5d141321699, content=<a href='/topic/show?id=1d7e48033f5' target=_blank style='color:#2F92EE;'>#左心室#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48033, encryptionId=1d7e48033f5, topicName=左心室)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=15012955474, createdName=wushaoling, createdTime=Tue Feb 13 05:59:00 CST 2018, time=2018-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1418748, encodeId=78651418e483f, content=<a href='/topic/show?id=e5be23919cf' target=_blank style='color:#2F92EE;'>#二尖瓣返流#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23919, encryptionId=e5be23919cf, topicName=二尖瓣返流)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ad623409629, createdName=kksonne, createdTime=Tue Feb 13 05:59:00 CST 2018, time=2018-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1463189, encodeId=b8e0146318979, content=<a href='/topic/show?id=cff92389310' target=_blank style='color:#2F92EE;'>#二尖瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23893, encryptionId=cff92389310, topicName=二尖瓣)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fdb26536308, createdName=wwzzly, createdTime=Tue Feb 13 05:59:00 CST 2018, time=2018-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562834, encodeId=7e381562834c2, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Tue Feb 13 05:59:00 CST 2018, time=2018-02-13, status=1, ipAttribution=)]
    2018-04-29 lsj637
  5. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1418748, encodeId=78651418e483f, content=<a href='/topic/show?id=e5be23919cf' target=_blank style='color:#2F92EE;'>#二尖瓣返流#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23919, encryptionId=e5be23919cf, topicName=二尖瓣返流)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ad623409629, createdName=kksonne, createdTime=Tue Feb 13 05:59:00 CST 2018, time=2018-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1463189, encodeId=b8e0146318979, content=<a href='/topic/show?id=cff92389310' target=_blank style='color:#2F92EE;'>#二尖瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23893, encryptionId=cff92389310, topicName=二尖瓣)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fdb26536308, createdName=wwzzly, createdTime=Tue Feb 13 05:59:00 CST 2018, time=2018-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562834, encodeId=7e381562834c2, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Tue Feb 13 05:59:00 CST 2018, time=2018-02-13, status=1, ipAttribution=)]
    2018-02-18 天涯183

    非常好的文章.学习了

    0

  6. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1418748, encodeId=78651418e483f, content=<a href='/topic/show?id=e5be23919cf' target=_blank style='color:#2F92EE;'>#二尖瓣返流#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23919, encryptionId=e5be23919cf, topicName=二尖瓣返流)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ad623409629, createdName=kksonne, createdTime=Tue Feb 13 05:59:00 CST 2018, time=2018-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1463189, encodeId=b8e0146318979, content=<a href='/topic/show?id=cff92389310' target=_blank style='color:#2F92EE;'>#二尖瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23893, encryptionId=cff92389310, topicName=二尖瓣)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fdb26536308, createdName=wwzzly, createdTime=Tue Feb 13 05:59:00 CST 2018, time=2018-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562834, encodeId=7e381562834c2, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Tue Feb 13 05:59:00 CST 2018, time=2018-02-13, status=1, ipAttribution=)]
    2018-02-13 zhaojie88
  7. 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href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Tue Feb 13 05:59:00 CST 2018, time=2018-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1413216, encodeId=4a5d141321699, content=<a href='/topic/show?id=1d7e48033f5' target=_blank style='color:#2F92EE;'>#左心室#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48033, encryptionId=1d7e48033f5, topicName=左心室)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=15012955474, createdName=wushaoling, createdTime=Tue Feb 13 05:59:00 CST 2018, time=2018-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1418748, encodeId=78651418e483f, content=<a href='/topic/show?id=e5be23919cf' target=_blank style='color:#2F92EE;'>#二尖瓣返流#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23919, encryptionId=e5be23919cf, topicName=二尖瓣返流)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ad623409629, createdName=kksonne, createdTime=Tue Feb 13 05:59:00 CST 2018, time=2018-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1463189, encodeId=b8e0146318979, content=<a href='/topic/show?id=cff92389310' target=_blank style='color:#2F92EE;'>#二尖瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23893, encryptionId=cff92389310, topicName=二尖瓣)], attachment=null, authenticateStatus=null, 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  8. 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  9. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1418748, encodeId=78651418e483f, content=<a href='/topic/show?id=e5be23919cf' target=_blank style='color:#2F92EE;'>#二尖瓣返流#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23919, encryptionId=e5be23919cf, topicName=二尖瓣返流)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ad623409629, createdName=kksonne, createdTime=Tue Feb 13 05:59:00 CST 2018, time=2018-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1463189, encodeId=b8e0146318979, content=<a href='/topic/show?id=cff92389310' target=_blank style='color:#2F92EE;'>#二尖瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23893, encryptionId=cff92389310, topicName=二尖瓣)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fdb26536308, createdName=wwzzly, createdTime=Tue Feb 13 05:59:00 CST 2018, time=2018-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562834, encodeId=7e381562834c2, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Tue Feb 13 05:59:00 CST 2018, time=2018-02-13, status=1, ipAttribution=)]
    2018-02-13 wwzzly
  10. 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createdAvatar=null, createdBy=fdb26536308, createdName=wwzzly, createdTime=Tue Feb 13 05:59:00 CST 2018, time=2018-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562834, encodeId=7e381562834c2, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Tue Feb 13 05:59:00 CST 2018, time=2018-02-13, status=1, ipAttribution=)]
    2018-02-13 slcumt