UNASSIGNED: A total of 16 patients with documented blood cobalt ion levels above 13 µg/l (13 ppb, 221 nmol/l) were identified from a regional arthroplasty database. They were matched with eight patients awaiting hip arthroplasty. All patients underwent echocardiography, including GLS, investigating potential signs of cardiomyopathy.
UNASSIGNED: Patients with MoM hip arthroplasties had a mean blood cobalt level of 29 µg/l (495 nmol/l) compared to 0.01 µg/l (0.2 nmol/l) in the control group. GLS readings were available for seven of the MoM cohort, and were significantly lower when compared with controls (-15.5% vs -18% (MoM vs control); p = 0.025)). Pearson correlation demonstrated that GLS significantly correlated with blood cobalt level (r = 0.8521; p < 0.001). However, there were no differences or correlations for other echocardiography measurements, including LVEF (64.3% vs 63.7% (MoM vs control); p = 0.845).
UNASSIGNED: This study supports the hypothesis that patients with elevated blood cobalt levels above 13 µg/l in the presence of a MoM hip implant may have impaired cardiac function compared to a control group of patients awaiting hip arthroplasty. It is the first study to use the more sensitive parameter of GLS to assess for any cardiac contractile dysfunction in patients with a MoM hip implant and a normal LVEF. Larger studies should be performed to determine the potential of GLS as a predictor of cardiac complications in patients with MoM arthroplasties.
■共有16例血钴离子水平超过13µg/l(13ppb,从区域关节成形术数据库中确定221nmol/l)。他们与八名等待髋关节置换术的患者相匹配。所有患者均行超声心动图检查,包括GLS,研究心肌病的潜在体征。
■患有MoM髋关节置换术的患者的平均血液钴水平为29µg/l(495nmol/l),而对照组为0.01µg/l(0.2nmol/l)。GLS读数可用于MoM队列中的七个,与对照组相比,显着降低(-15.5%vs-18%(MoMvs对照组);p=0.025))。Pearson相关性显示GLS与血钴水平显著相关(r=0.8521;p<0.001)。然而,其他超声心动图测量没有差异或相关性,包括LVEF(64.3%vs63.7%(MoMvs对照组);p=0.845)。
■这项研究支持以下假设:与等待髋关节置换术的对照组患者相比,在MoM髋关节植入物存在的情况下血钴水平高于13µg/l的患者可能具有心脏功能受损。这是第一项使用GLS更敏感的参数来评估MoM髋关节植入物和正常LVEF患者的任何心脏收缩功能障碍的研究。应进行更大规模的研究,以确定GLS作为MoM关节置换术患者心脏并发症的预测指标。