Khảo sát một số đặc điểm lâm sàng, cận lâm sàng và sức căng dọc thất trái trên siêu âm đánh dấu mô cơ tim 2D ở bệnh nhân phẫu thuật thay van động mạch chủ được theo dõi sau 6 tháng=Assessment of clinical, subclinical characteristics and left ventricular global longitudinal strain by 2D speckle-tracking echocardiography in patients undergoing aortic valve replacement over six-month follow-up

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Đức Hải Nguyễn, Thị Ngọc Lan Trần, Văn Riệp Trần

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y dược lâm sàng 108, 2024

Mô tả vật lý: tr.19-23

Bộ sưu tập: Metadata

ID: 244803

Thêm vào giỏ

Assessment of clinical, subclinical characteristics and left ventricular global longitudinal strain by 2D speckle-tracking echocardiography in patients undergoing aortic valve replacement over six- month follow-up. Subject and method: 96 patients with severe aortic stenosis and 74 patients with severe aortic regurgitation undergoing aortic valve replacement (mean age: 60.9 ± 10.6 years
59.4% were male). Study variables included NYHA, Sokolow Lyon index, ejection fraction (EF), left ventricular global longitudinal strain by 2D speckle-tracking echocardiography (GLS). Result: Six-month follow-up after valve replacement, the NYHA ≥ 2 decreased from 98.8% to 32%
Sokolow Lyon index decreased from 37.5 ± 2.1mm to 25.1 ± 3.8mm in the aortic stenosis group and from 41.7 ± 2.8mm to 28.8 ± 2.9mm in the aortic regurgitation group (p<
0.001)
EF significantly increased at six-month follow-up (aortic stenosis: 61.4 ± 11.1% to 71.8 ± 9.8%
aortic regurgitation: 58.8 ± 11.1% to 69.8 ± 9.6%
p<
0,05). Preoperative GLS decreased in both aortic stenosis/aortic regurgitation groups despite preserved ejection fraction (aortic stenosis: -16.1 ± 3.5% and aortic regurgitation -14.7 ± 3.2%). Six-month follow-up after replacement, the absolute value of GLS increased (aortic stenosis group: -16.1 ± 3.5% vs -19.4 ± 1.9%
aortic regurgitation: -14.7 ± 3.2% vs -18.7 ± 1.9%). Conclusion: (1) Our results indicate that significant improvements of NYHA, Sokolow Lyon index, EF and GLS can be observed in patients undergoing aortic valve replacement. (2) GLS is a more sensitive marker for early myocardial damage than EF in patients with aortic stenosis/aortic regurgitation.Khảo sát một số đặc điểm lâm sàng, cận lâm sàng và sức căng dọc thất trái trên siêu âm đánh dấu mô cơ tim 2D ở bệnh nhân phẫu thuật thay van động mạch chủ được theo dõi sau 6 tháng. Đối tượng và phương pháp: 96 bệnh nhân hẹp chủ khít (HC) và 74 bệnh nhân hở van động mạch chủ nhiều (HoC) được phẫu thuật thay van động mạch chủ (ĐMC)
tuổi trung bình 60,9 ± 10,6 năm
giới nam 59,4%. Các biến nghiên cứu gồm: Mức độ khó thở (theo phân loại NYHA), mức độ phì đại thất trái điện tâm đồ (chỉ số Sokolow Lyon), phân suất tống máu trên siêu âm tim (EF), sức căng dọc thất trái trên siêu âm đánh dấu mô cơ tim 2D (GLS). Kết quả: Sau phẫu thuật 6 tháng, tỷ lệ khó thở (NYHA ≥ 2) giảm từ 98,8% xuống 32%. Chỉ số Sokolow Lyon giảm từ 37,5 ± 2,1mm xuống 25,1 ± 3,8mm ở nhóm HC và từ 41,7 ± 2,8mm xuống 28,8 ± 2,9mm ở nhóm HoC (p<
0,001). EF tăng từ 61,4 ± 11,1% lên 71,8 ± 9,8% ở nhóm HC
từ 58,8 ± 11,1% lên 69,8 ± 9,6% ở nhóm HoC. GLS trước phẫu thuật giảm ở cả 2 nhóm HC/HoC mặc dù phân suất tống máu bảo tồn (HC: -16,1 ± 3,5% và HoC -14,7 ± 3,2%). Sau phẫu thuật 6 tháng, trị tuyệt đối GLS tăng (nhóm HC: -16,1 ± 3,5% so với -19,4 ± 1,9%
HoC: -14,7 ± 3,2% so với -18,7 ± 1,9%). Kết luận: Phẫu thuật thay van ĐMC làm giảm khó thở, giảm phì đại thất trái, tăng EF và tăng trị tuyệt đối của GLS ở cả nhóm HC và HoC. GLS là một dấu hiệu nhạy hơn EF để phát hiện sớm tổn thương cơ tim ở bệnh nhân hẹp chủ/hở chủ.

1. Đọc trực tuyến

1. Đọc trực tuyến

Tạo bộ sưu tập với mã QR