JACC:心肌水肿和淀粉样变性

2018-06-26 MedSci MedSci原创

轻链(AL)和甲状旁腺素(ATTR)淀粉样变患者的预后受心脏表现的影响。ATTR淀粉样变的预后优于AL淀粉样变,提示AL淀粉样变发表机制的不同。本研究的目的旨在评估淀粉样变性患者心肌水肿的发生率及其对预后的影响。本研究纳入了286名淀粉样变患者,其中100名为系统性AL淀粉样变,163名为心脏ATTR淀粉样变,12名为疑似心脏ATTR淀粉样变患者,11名为无症状的淀粉样TTR基因突变携带者,30名

轻链(AL)和甲状旁腺素(ATTR)淀粉样变患者的预后受心脏表现的影响。ATTR淀粉样变的预后优于AL淀粉样变,提示AL淀粉样变发表机制的不同。本研究的目的旨在评估淀粉样变性患者心肌水肿的发生率及其对预后的影响。

本研究纳入了286名淀粉样变患者,其中100名为系统性AL淀粉样变,163名为心脏ATTR淀粉样变,12名为疑似心脏ATTR淀粉样变患者,11名为无症状的淀粉样TTR基因突变携带者,30名正常对照。所有研究对象均接受了心脏磁共振检查,16名接受了心内膜心肌活检。分析结果显示,心肌T2信号在淀粉样变患者中明显增高,其中在未接受治疗的AL患者中增高最明显。与AL淀粉样变患者相比,ATTR淀粉样变患者的左室质量和细胞外体积分数更高,而左室射血分数更低。在87.5%的心肌活检患者中检测出心脏水肿。Cox回归分析后发现,心肌T2信号可以预测AL淀粉样变患者死亡风险。

本研究结果显示,心脏淀粉样变患者会出现心肌水肿,且心脏磁共振T2信号在未接受治疗的AL患者中更高,是预测AL淀粉样变患者预后的因子之一。

原始出处:
Tushar K et al.Myocardial Edema and Prognosis in Amyloidosis.JACC.2018 Jun.

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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=327254, encodeId=93a932e25419, content=认真学习.把间接经验应用到临床实践中去.然后再总结出新思路.给点赞啦, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Tue Jun 26 23:56:52 CST 2018, time=2018-06-26, status=1, ipAttribution=)]
    2018-12-06 hbwxf
  2. 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    2018-06-29 1e0f8808m18(暂无匿称)

    好文章.学习了.

    0

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  4. 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12:04:00 CST 2018, time=2018-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=327419, encodeId=1c2532e4195f, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Wed Jun 27 10:56:15 CST 2018, time=2018-06-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=327323, encodeId=964132e323d7, content=好文献学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b5a62240667, createdName=张新亮1853311252142e2fm, createdTime=Wed Jun 27 06:29:12 CST 2018, time=2018-06-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=327254, encodeId=93a932e25419, content=认真学习.把间接经验应用到临床实践中去.然后再总结出新思路.给点赞啦, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Tue Jun 26 23:56:52 CST 2018, time=2018-06-26, status=1, ipAttribution=)]
    2018-06-28 小华子
  5. 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  6. 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  7. 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12:04:00 CST 2018, time=2018-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=327419, encodeId=1c2532e4195f, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Wed Jun 27 10:56:15 CST 2018, time=2018-06-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=327323, encodeId=964132e323d7, content=好文献学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b5a62240667, createdName=张新亮1853311252142e2fm, createdTime=Wed Jun 27 06:29:12 CST 2018, time=2018-06-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=327254, encodeId=93a932e25419, content=认真学习.把间接经验应用到临床实践中去.然后再总结出新思路.给点赞啦, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Tue Jun 26 23:56:52 CST 2018, time=2018-06-26, status=1, ipAttribution=)]
    2018-06-28 huangdf
  8. 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12:04:00 CST 2018, time=2018-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=327419, encodeId=1c2532e4195f, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Wed Jun 27 10:56:15 CST 2018, time=2018-06-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=327323, encodeId=964132e323d7, content=好文献学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b5a62240667, createdName=张新亮1853311252142e2fm, createdTime=Wed Jun 27 06:29:12 CST 2018, time=2018-06-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=327254, encodeId=93a932e25419, content=认真学习.把间接经验应用到临床实践中去.然后再总结出新思路.给点赞啦, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Tue Jun 26 23:56:52 CST 2018, time=2018-06-26, status=1, ipAttribution=)]
    2018-06-27 131****1460

    学习了受益匪浅

    0

  9. 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12:04:00 CST 2018, time=2018-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=327419, encodeId=1c2532e4195f, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Wed Jun 27 10:56:15 CST 2018, time=2018-06-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=327323, encodeId=964132e323d7, content=好文献学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b5a62240667, createdName=张新亮1853311252142e2fm, createdTime=Wed Jun 27 06:29:12 CST 2018, time=2018-06-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=327254, encodeId=93a932e25419, content=认真学习.把间接经验应用到临床实践中去.然后再总结出新思路.给点赞啦, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Tue Jun 26 23:56:52 CST 2018, time=2018-06-26, status=1, ipAttribution=)]
    2018-06-27 张新亮1853311252142e2fm

    好文献学习了

    0

  10. 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12:04:00 CST 2018, time=2018-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=327419, encodeId=1c2532e4195f, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Wed Jun 27 10:56:15 CST 2018, time=2018-06-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=327323, encodeId=964132e323d7, content=好文献学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b5a62240667, createdName=张新亮1853311252142e2fm, createdTime=Wed Jun 27 06:29:12 CST 2018, time=2018-06-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=327254, encodeId=93a932e25419, content=认真学习.把间接经验应用到临床实践中去.然后再总结出新思路.给点赞啦, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Tue Jun 26 23:56:52 CST 2018, time=2018-06-26, status=1, ipAttribution=)]
    2018-06-26 虈亣靌

    认真学习.把间接经验应用到临床实践中去.然后再总结出新思路.给点赞啦

    0

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