术前右心室纵向应变作为 Ebstein 异常术后残留或复发三尖瓣反流的预后指标：一项心血管磁共振研究。

IF 2.1 3区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Cardiovascular diagnosis and therapy Pub Date : 2024-08-31 Epub Date: 2024-08-05 DOI:10.21037/cdt-24-63

Xiahui Tian, Yuelong Yang, Xinyi Luo, Liqi Cao, Xiaobing Zhou, Huanwen Xu, Rui Chen, Ruohong Luo, Hui Liu

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引用次数: 0

摘要

背景：对于埃布斯坦畸形（EA）患者，锥体重建（CR）术后三尖瓣反流（TR）残留或复发的术前预测因素仍不明确。我们的目的是确定使用心脏磁共振（CMR）成像评估的右心室纵向应变对 EA 患者 CR 后残留或复发 TR 的预测价值：这项单中心回顾性研究分析了2017年1月至2023年2月期间在CR前接受CMR检查的48例EA患者的数据[平均值±标准差（SD），年龄35.0±13.6岁；男性13例]。在CR前和CR后中期（大于6个月）进行了二维彩色多普勒超声心动图检查，以评估EA患者的TR程度。30名健康志愿者作为对照组。研究人员进行了单变量和多变量逻辑回归分析，以确定CR术后6个月以上中度或重度TR的CMR预测因素：术后中期结果显示，分别有 8 例（17%）、7 例（15%）和 33 例（69%）患者出现重度、中度和轻度 TR。与轻度 TR 患者相比，CR 术后 6 个月的 EA 和中度或重度 TR 患者的左心室整体纵向应变（GLS）、左心室射血分数、右心室整体纵向应变（RVGLS）和右心室射血分数（RVEF）明显降低[几率比（OR）1.193，95% 置信区间（CI）：1.025-1.388；P=0.02]：RVGLS是CR后6个月以上中度或重度TR的重要预测因素。这一发现强调，早期准确测量 RV 功能有助于识别严重残余或复发 TR 的高危患者。

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Preoperative right ventricular longitudinal strain as a prognosticator of postoperative residual or recurrent tricuspid regurgitation in Ebstein anomaly: a cardiovascular magnetic resonance study.

Background: The preoperative predictors of residual or recurrent tricuspid regurgitation (TR) after cone reconstruction (CR) remains unclear in patients with Ebstein anomaly (EA). We aimed to determine the predictive value of right ventricular longitudinal strain, assessed using cardiac magnetic resonance (CMR) imaging, for residual or recurrent TR after CR in patients with EA.

Methods: This single-centre, retrospective study analysed data from 48 patients with EA [mean ± standard deviation (SD), age, 35.0±13.6 years; 13 males] who underwent CMR before CR between January 2017 and February 2023. Two-dimensional colour Doppler echocardiography was performed before CR and mid-term (>6 months) after CR to evaluate the degree of TR in patients with EA. Thirty healthy volunteers served as controls. Univariate and multivariate logistic regression analyses were performed to identify CMR predictors of moderate or severe TR >6 months after CR.

Results: Mid-term postoperative results revealed severe, moderate, and mild TR in 8 (17%), 7 (15%), and 33 (69%) patients, respectively. For patients with EA and moderate or severe TR after CR, left ventricular global longitudinal strain (GLS), left ventricular ejection fraction, right ventricular global longitudinal strain (RVGLS), and right ventricular ejection fraction (RVEF) were significantly worse compared to patients with mild TR (all P<0.05). Multivariate logistic regression analyses revealed that RVGLS was independently associated with moderate or severe TR >6 months after CR [odds ratio (OR) 1.193, 95% confidence interval (CI): 1.025-1.388; P=0.02].

Conclusions: RVGLS was a significant predictor of moderate or severe TR >6 months after CR. This finding emphasizes that early and accurate measurement of RV function may help to identify patients at high risk for severe residual or recurrent TR.

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来源期刊

Cardiovascular diagnosis and therapy Medicine-Cardiology and Cardiovascular Medicine

CiteScore

4.90

自引率

4.20%

发文量

期刊介绍： The journal ''Cardiovascular Diagnosis and Therapy'' (Print ISSN: 2223-3652; Online ISSN: 2223-3660) accepts basic and clinical science submissions related to Cardiovascular Medicine and Surgery. The mission of the journal is the rapid exchange of scientific information between clinicians and scientists worldwide. To reach this goal, the journal will focus on novel media, using a web-based, digital format in addition to traditional print-version. This includes on-line submission, review, publication, and distribution. The digital format will also allow submission of extensive supporting visual material, both images and video. The website www.thecdt.org will serve as the central hub and also allow posting of comments and on-line discussion. The web-site of the journal will be linked to a number of international web-sites (e.g. www.dxy.cn), which will significantly expand the distribution of its contents.