Eur Heart J-Card Img:主动脉狭窄患者检测心脏淀粉样变的超声心动图指标

2022-08-14 MedSci原创 MedSci原创

基于超声心动图检查的参数在检测AS患者CA方面有很大的前景。进一步的研究应该探索这些超声心动图变量的最佳临界值,以获得更好的诊断准确性。

主动脉瓣狭窄(Aorticstenosis,AS)和心脏淀粉样变(Cardiacamyloidosis,CA)常常同时存在,但在AS患者中CA的诊断仍然是一个挑战。

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,研究人员的目的是评估超声心动图参数,这可能有助于在AS患者中检测有无CA。

研究人员对电子数据库中的同行评议文献进行了系统的文献检索,检索时间从数据库成立到2022年1月10日。在纳入的1449例患者中,160例患者同时患有AS和CA,而剩下的1289例患者仅患有AS。

研究人员通过Meta分析,结果显示室间隔厚度[标准化均数差值为0.74,95%CI为0.36-1.12,P=0.0001)、相对壁厚(标准化均数差值为0.74,95%CI为0.17-1.30,P<0.0001)、后壁厚度(标准化均数差值为0.74,95%CI为0.51-0.97,P=0.0011)、左室质量指数(标准化均数差值为1.62,95%CI为0.63-2.62,P=0.0014)、E/A比值(标准化均数差值为4.18,95%CI为1.91-6.46,P=0.0003)和LA维度(标准化均数差值为0.73,95%CI为0.43-1.02,P<0.0001)]在同时患有AS和CA的患者中显著高于单纯AS患者。与此相反,同时患有AS和CA患者的心肌收缩分数(标准化均数差值为−2.88,95%CI为−5.70~−0.06,P=0.045)、平均二尖瓣环S′(标准化均数差值为−1.14,95%CI为−1.86~−0.43,P=0.0017)、三尖瓣环平面收缩幅度(标准化均数差值为−0.36,95%CI为−0.62~−0.09,P=0.0081)和三尖瓣环S′(标准化均数差值为−0.77,95%CI为−1.13~−0.42,P<0.0001)显著降低。

由此可见,基于超声心动图检查的参数在检测AS患者CA方面有很大的前景。进一步的研究应该探索这些超声心动图变量的最佳临界值,以获得更好的诊断准确性。

 

原始出处:

Vikash Jaiswal.et al.Echocardiographic predictors of presence of cardiac amyloidosis in aortic stenosis.Eur Heart J-Card Img. 2022.https://academic.oup.com/ehjcimaging/advance-article/doi/10.1093/ehjci/jeac146/6655774

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    2022-08-09 zhaojie88
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    2022-08-09 slcumt

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