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Eur Heart J-Card Img:慢性阻塞性肺疾病急性心肌梗死后左室整体纵向应变与长期预后!

2018-03-01 xing.T MedSci原创

由此可见,左心室GLS受损与伴有COPD的STEMI患者糟糕的长期生存率独立相关,并会增加LVEF的预测价值。

左心室(LV)收缩功能是ST段抬高型心肌梗死(STEMI)患者的一个已知预后因素。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,研究人员旨在评价左心室整体纵向应变(GLS)在慢性阻塞性肺疾病(COPD)患者发生STEMI后的预后价值。

研究人员对一百四十三名伴有COPD的STEMI患者(平均年龄为70±11 岁,71%为男性)进行了回顾性分析。入院后48 小时内受试者通过经胸超声心动图测定了左室射血分数(LVEF)和左室GLS。患者随访至全因死亡和全因死亡以及心力衰竭住院的联合终点发生。

中位随访68(四分位距为38.5-99)个月,66例(46%)患者死亡,70例(49%)患者发生复合终点。平均左室GLS为-14.4%。LV的GLS>-14.4%的患者表现出较高的全因死亡(在随访1年、2年和5 年分别为19%、26%和44% vs. 7%、8%和18%;P=0.004  )和复合终点(26%、34%和50% vs. 8%、10%和20%;P=0.001)累积发生率,相比于左室GLS≤-14.4%的患者。在多变量分析中,左室GLS>-14.4%与增加的全因死亡和复合终点独立相关[风险比(HR)为2.07;P=0.02  和HR为2.20;P=0.01]。

由此可见,左心室GLS受损与伴有COPD的STEMI患者糟糕的长期生存率独立相关,并会增加LVEF的预测价值。

原始出处:

Laurien Goedemans,et al. Left ventricular global longitudinal strain and long-term prognosis in patients with chronic obstructive pulmonary disease after acute myocardial infarction. Eur Heart J-Card Img. 2018. https://doi.org/10.1093/ehjci/jey028

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    2018-04-06 tomyang96
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    2018-03-02 zhaojie88
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    2018-03-02 slcumt

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