■左心室(LV)体积的顺序测定构成了任何心脏移植(HTX)患者机械性能评估的基础。对体积数据的全面分析提供了对适应和病理生理学的独特见解。
■重点关注八个连续双平面血管造影左心室收缩末期容积(ESV)测定,我们评估了1例年龄为61岁的男性患者(女性供者)接受HTX治疗后的临床过程.这位前吸烟者有慢性阻塞性肺疾病史,高血压,高胆固醇血症难以治疗,并表现为多支血管冠状动脉疾病。后来的过程并发了肺动脉高压,腹主动脉瘤,和继发性慢性肾病。肺栓塞再发作后,病人在79岁时去世。在某一时刻,ESV比起始值高>700%,实际上远远超过了所评估的任何其他基于体积的度量的相对变化,包括射血分数(EF)。
■HTX患者左心室体积数据的纵向研究为重塑和性别特异性适应过程的病理生理学提供了独特的窗口。本病例记录了对系列发现的适当分析形成了有关疾病进展的临床相关信息的丰富来源。收缩末期容积是主要指标,与流行的度量EF相反。这一发现得到了文献中报道的基于人群的研究的支持。我们得出的结论是,对体积数据进行综合分析,特别是ESV,有助于个性化医疗,并增强对LV(反向)重塑的洞察力,同时也告知预后。
UNASSIGNED: Sequential determinations of left ventricular (LV) volume constitute a cornerstone in the mechanical performance evaluation of any heart transplant (HTX) patient. A comprehensive analysis of volumetric data offers unique insight into adaptation and pathophysiology.
UNASSIGNED: With a focus on eight sequential biplane angiocardiographic LV end-systolic volume (ESV) determinations, we evaluate the clinical course of a male patient following HTX (female donor) at the age of 61 years. This former smoker had a history of chronic obstructive pulmonary disease, hypertension, and hypercholesterolaemia refractory to treatment, and presented with multivessel coronary artery disease. The later course was complicated by pulmonary hypertension, an abdominal aortic aneurysm, and secondary chronic kidney disease. After an additional episode of pulmonary embolism, the patient died at the age of 79. At one point, the ESV was > 700% higher than the starting value, and actually by far exceeded the relative change of any other volume-based metric evaluated, including ejection fraction (EF).
UNASSIGNED: The longitudinal study of LV volumetric data in HTX patients offers a unique window to the pathophysiology of remodelling and sex-specific adaptation processes. The present
case documents that proper analysis of serial findings form a rich source of clinically relevant information regarding disease progression. End-systolic volume is the primary indicator, in contrast to the popular metric EF. This finding is supported by population-based studies reported in the literature. We conclude that comprehensive analysis of volumetric data, particularly ESV, contributes to personalized medicine and enhances insight into LV (reverse) remodelling, while also informing about prognosis.