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JAHA:左房应变可预测窦性心律的急性心衰患者卒中风险

2021-06-30 MedSci原创 MedSci原创

在伴有窦性心律的急性HF患者中,LAGLS降低(<14.5%)与卒中风险增加相关,其年发病率为2.38%。

卒中是心力衰竭(HF)患者的主要合并症,尤其是左心房(LA)功能下降的患者,因此,识别卒中高危患者可以预防其发生。

近日,血管疾病领域权威杂志JAHA上发表了一篇研究文章,研究人员旨在评估LA整体纵向应变(LAGLS)对急性HF和窦性心律患者的预测价值。

在这项回顾性研究中,来自3家三级医院的4312名连续急性HF患者中,2461名患者(53.3%为男性,69.7±14.4岁)伴有窦性心律和LAGLS。HF定义为射血分数(EF)降低的HF(左心室EF≤40%)、中等范围EF的HF(40%<左心室EF<50%)和射血分数正常的HF(左心室EF≥50%)。该研究的主要结局是新发卒中。

无事件生存曲线

参与者平均左心室EF为39.4%±15.6%。此外,研究人员回顾性地将1388(57.5%)、342(14.2%)和682(28.3%)归类为EF降低的HF、中等范围EF的HF和EF正常的HF。LAGLS为17.2%±10.4%。在随访期间(平均为30.3±25.4个月),100名患者发生卒中。与没有卒中的患者相比,卒中患者的LA直径更大(P=0.031),LAGLS更低(P=0.010)。在单变量分析中,年龄、糖尿病、LA直径、LA容积指数和LAGLS是卒中的重要危险因素。在多变量分析中,LAGLS每降低1%,卒中险就会增加3.8%(风险比[HR]为1.038;95%CI为1.013–1.065;P=0.003)。当将LAGLS的临界点设定为14.5%时,调整其他重要变量后,LAGLS<14.5%的患者发生卒中的风险升高约为两倍(HR为1.940;95%CI为1.269–2.965;P=0.002)。
 
由此可见,在伴有窦性心律的急性HF患者中,LAGLS降低(<14.5%)与卒中风险增加相关,其年发病率为2.38%。

原始出处:

Jae‐Hyeong Park.et al.Left Atrial Strain to Predict Stroke in Patients With Acute Heart Failure and Sinus Rhythm.J AM HEART ASSOC.2021.https://www.ahajournals.org/doi/full/10.1161/JAHA.120.020414

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    2021-07-02 zhaohui6731
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    2021-06-30 健健

    卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!

    0

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    2021-06-30 guging

    中风是俗称,应该称为缺血性卒中吧

    0

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