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Circ-Heart Fail:主动脉波形分析有助于心衰个体化治疗

2017-02-13 xing.T MedSci原创

升高的主动脉压力波搏动以及治疗导致的更大程度的搏动减少与接受积极的血管扩张剂滴定的射血分数降低心衰患者功能改善有关。这些差异采用臂袖带血压是无法识别的。中央主动脉波形分析可以使射血分数降低的慢性心衰患者更好地接受个性化的血管活性药物治疗。

降低后负荷是射血分数降低的心衰患者治疗的基石。然而,动脉负荷和心衰治疗对后负荷的效应可能因人而异。心衰患者量身定制血管活性药物是基于对动脉后负荷更好的理解可以使治疗更加个性化。近日,心血管领域权威杂志Circ-Heart Fail上针对这一问题发表了一篇研究文章。

射血分数降低的心衰受试者进行了积极的血管活性药物心衰治疗滴定,通过采用脉搏波、波分离以及动脉储备模型评估了中央主动脉波形。研究人员采用6min步行试验距离来评估治疗的临床疗效。

研究人员发现其中有25例患者6min步行试验距离有所增加,而有13例患者发生了下降或保持不变。相比于没有出现治疗改善的受试者,出现治疗改善的受试者在进入研究之时展现出了较高的主动脉压力波搏动(中央脉压[PP]、反射的压力波和储备压力)(所有P均<0.05)。由动脉分析方法得到的参数彼此强烈相关,并且展示出了类似的预测改善效能。功能改善的受试者主动脉压力搏动明显下降,而在那些没有出现功能改善的受试者中并没有观察到显著改变(相互作用P<0.05)。在基线和治疗时动脉负荷的这些差异与从传统的肱动脉袖带压力评估所得到的没有明显的差异。

由此可见,升高的主动脉压力波搏动以及治疗导致的更大程度的搏动减少与接受积极的血管扩张剂滴定的射血分数降低心衰患者功能改善有关。这些差异采用臂袖带血压是无法识别的。中央主动脉波形分析可以使射血分数降低的慢性心衰患者更好地接受个性化的血管活性药物治疗。

原始出处:

Peter Wohlfahrt, et al. Aortic Waveform Analysis to Individualize Treatment in Heart Failure. Circulation:heart failure. 2017. 

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    2017-02-15 zhaojie88
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    2017-02-15 slcumt
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