The influence of pressure injury risk on the association between left ventricular ejection fraction and all-cause mortality in patients with acute myocardial infarction 80 years or older

BACKGROUND: We aimed to investigate whether the pressure injury risk mediates the association of left ventricular ejection fraction(LVEF) with all-cause death in patients with acute myocardial infarction(AMI) aged 80 years or older.METHODS: This retrospective cohort study included 677 patients with AMI aged 80 years or older from a tertiary-level hospital. Pressure injury risk was assessed using the Braden scale at admission, and three risk groups(low/minimal, intermediate, high) were defined according to the overall score of six different variables. LVEF was measured during the index hospitalization for AMI. All-cause death after hospital discharge was the primary outcome.RESULTS: Over a median follow-up period of 1,176 d(interquartile range [IQR], 722–1,900 d), 226(33.4%) patients died. Multivariate Cox regression analysis showed that reduced LVEF was associated with an increased risk of all-cause death only in the high-risk group of pressure injury(adjusted hazard ratios [HR]=1.81, 95% confidence interval [CI]: 1.03–3.20;P=0.040), but not in the low/minimal-(adjusted HR=1.29, 95%CI: 0.80–2.11;P=0.299) or intermediate-risk groups(adjusted HR=1.14, 95%CI: 0.65–2.02;P=0.651). Significant interactions were detected between pressure injury risk and LVEF(adjusted P=0.003). The cubic spline with hazard ratio plot revealed a distinct shaped curve relation between LVEF and all-cause death among different pressure injury risk groups.CONCLUSIONS: In older patients with AMI, the risk of pressure injury mediated the association between LVEF and all-cause death. The classification of older patients for both therapy and prognosis assessment appears to be improved by the incorporation of pressure injury risk assessment into AMI care management.

Interaction between the left ventricular ejection fraction and left ventricular strain and its relationship with coronary stenosis

BACKGROUND Coronary artery stenosis(CAS)is the most common type of heart disease and the leading cause of death in both men and women globally.CAS occurs when the arteries that supply blood to the heart muscle harden and become narrower due to plaque buildup-cholesterol and other material-on their inner walls.As a result,the heart muscle cannot receive the blood or oxygen it needs.Most heart attacks happen when a blood clot suddenly cuts off the hearts'blood supply,causing permanent heart damage.AIM To analyze the relationship between the left ventricular ejection fraction(LVEF),left ventricular strain(LVS),and coronary stenosis.METHODS A total of 190 participants were enrolled in this trail.The control group comprised 93 healthy individuals,and observation group comprised 97 patients with coronary heart disease who were hospitalized between July 2020 and September 2021.Coronary lesions were assessed using the Gensini score,and the LVEF and LVS were measured using magnetic resonance imaging(MRI).The interaction between the LVEF and LVS was examined using a linear regression model.The relationship between LVEF and coronary stenosis was examined using Spearman’s correlation.RESULTS The LVEF of the observation group was lower than that of the control group.The left ventricular end-systolic volume(LVESV)and left ventricular end-diastolic volume(LVEDV)of the observation group were significantly higher than those of the control group(P<0.05).The longitudinal and circumferential strains(LS,CS)of the observation group were significantly higher than those of the control group;however,the radial strain(RS)of the observation group was significantly lower than that of the control group(P<0.05).LVS,LS,and CS were significantly negatively correlated with the LVEF,and RS was positively correlated with the LVEF.There were significant differences in the LVEF,LVESV,and LVEDV of patients with different Gensini scores;the LVEF significantly decreased and the LVESV and LVEDV increased with increasing Gensini scores(P<0.05).In the observation group,the LVEF was negatively correlated and the LVESV and LVEDV were positively correlated with coronary stenosis(P<0.05).CONCLUSION The LVEF measured using MRI is significantly linearly correlated with LVS and negatively correlated with coronary stenosis.

The Clinical Association of Left Atrial Function with Left Ventricular Ejection Fraction

The left atrium (LA) has been recognized as a morphophysiological barometer of left ventricular (LV) diastolic dysfunction. Because in the myocardial ischemia cascade where LV diastolic dysfunction often precedes LV systolic dysfunction, the LA which fashions as an early marker of diastolic anomaly, could equally reflect a declining LV function and/or be a good predictor of potential sequelae. We assessed this association of LA function with reduced LV systolic function among hospitalized patients. Among patients with reduced LV ejection fraction, LA passive ejection fraction was lower (0.172 ± 0.12 vs. 0.232 ± 0.14, p = 0.013) whereas LA kinetic energy was higher (6.48 ± 6.3 vs. 4.57 ± 3.5, p = 0.005). Echocardiographic assessment of LA function, therefore, appears correlated with LVEF and could be important when risk stratifying hospitalized patients.

Left bundle branch pacing vs biventricular pacing in heart failure patients with left bundle branch block:A systematic review and meta-analysis

BACKGROUND Left bundle branch pacing(LBBP)is a novel pacing modality of cardiac resynchronization therapy(CRT)that achieves more physiologic native ventricular activation than biventricular pacing(BiVP).AIM To explore the validity of electromechanical resynchronization,clinical and echocardiographic response of LBBP-CRT.METHODS Systematic review and Meta-analysis were conducted in accordance with the standard guidelines as mentioned in detail in the methodology section.RESULTS In our analysis,the success rate of LBBP-CRT was determined to be 91.1%.LBBP CRT significantly shortened QRS duration,with significant improvement in echocardiographic parameters,including left ventricular ejection fraction,left ventricular end-diastolic diameter and left ventricular end-systolic diameter in comparison with BiVP-CRT.CONCLUSION A significant reduction in New York Heart Association class and B-type natriuretic peptide levels was also observed in the LBBP-CRT group vs BiVP-CRT group.Lastly,the LBBP-CRT cohort had a reduced pacing threshold at follow-up as compared to BiVP-CRT.

Heart failure with reduced,mildly reduced,or preserved left ventricular ejection fraction:Has reasoning been lost?

Left ventricular(LV)ejection fraction(LVEF),defined as LV stroke volume divided by end-diastolic volume,has been systematically used for the diagnosis,classification,and management of heart failure(HF)over the last three decades.HF is classified as HF with reduced LVEF,HF with midrange or mildly reduced LVEF,and HF with preserved LVEF using arbitrary,continuously changing LVEF cutoffs.A prerequisite for using this LVEF-based terminology is knowledge of the LVEF normal range,which is lacking and may lead to erroneous conclusions in HF,especially at the higher end of the LVEF spectrum.

Correction of hypovitaminosis D improved global longitudinal strain earlier than left ventricular ejection fraction in cardiovascular older adults after orthopaedic surgery

BackgroundCardiovascular 疾病和维生素 D 的不够的层次是为不利外科的结果的风险因素，并且他们是在经历整形外科的外科的更老的成年人之中通常在场的两个。给维生素 D 的心血管的效果， hypovitaminosis D 的外科手术前的诊断将是为补充协议的实现的珍贵的步。如果，我们调查了浆液 25 的正规化[哦] D 能改善受不了心血管的 diseases.MethodsWe 的更老的成年人的心脏的性能注册了为主要整形外科的外科安排的 47 个更老的成年人并且受不了 hypovitaminosis D。病人们与开始的剂量经历了 6 月的 calcifediol 补充 50 湩琠敨攠敶瑮的起初手术后的白天吗？

Effect of exercise on left and right ventricular ejection fraction and wallmotion in patients with coronary artery disease: an ultrafast computed tomography study

To measure the response of left and right ventricular ejection fraction and wall motion to exercise in eighteen patients with angiogl’aphically documented coronary artery disease (CAD) and in twenty-two patients with angiographicallynormal coronary arteries using ultrafast computed tomography(UFCT). Methods: Angiography and UFCT exercise cine studieswere performed for the evaluation of chest pain in all 40 cases, including 18 CAD patients and 22 patients with normal coronary arteries. Results: Of the 18 patients with CAD, 14(78% ) had a≥5% decrease in left ventricular ejection fraction (LVEF) duringexercise by UFCT (P< 0 .001), and 14 (78%) had an abnormal response in left ventricular wall motion during exercise, (aworsened or newly-developed reginal RV wall motion abnormality (RVWMA)) during exercise. In the 22 normal patients, onlyone had a decrease in LVEF > 5%; none had an abnormal response in LV wall motion during peak exercise or a RVWMA at restor during stress. Using a decrease of ≥5 % in LVEF or a LVWMA or RVWMA during stress as a criterion for identifying patientswith CAD, the accuracy was 88% (35/40) with LVEF, 90% (36/40) with LVWMA, and 92% (37/40) with a combination ofLVEF, LVWMA and RVWMA. The sensitivity of RVWMA alone in detecting right coronary artery disease (RCAD) was 60%(6/10) and the specificity was 78% (7/9). Conclusion: Our study suggests that exercise-UFCT appears to be a useful tool for thedetection of CAD in patients with chest pain. The abnormal response of LVEF and exercise-induced LVWMA and RVWMA as determined by UFCT were important predictors CAD. Both LVWMA and RVWMA of important value in identifying patientswith CAN from those with normal coronary arteries, as is RVWMA in defining the existence of RCAD in patients with CAD.

CHA2DS2-VASc评分联合LVEF预测慢性心力衰竭合并永久性心房颤动患者发生认知功能障碍的价值

目的探讨心房颤动血栓发生危险度(CHA2DS2-VASc)评分联合左心室射血分数(LVEF)预测慢性心力衰竭合并永久性心房颤动患者发生认知功能障碍的价值。方法回顾性分析2019年12月至2021年12月郑州市中心医院收治的299例慢性心力衰竭合并永久性心房颤动患者的资料,根据是否发生认知功能障碍分为认知功能障碍组和认知功能正常组。分析CHA2DS2-VASc评分联合LVEF预测慢性心力衰竭合并永久性心房颤动患者发生认知功能障碍的价值。结果认知功能障碍组患者性别、受教育程度、吸烟史、糖尿病、脑卒中、NYHA分级构成比与认知功能正常组患者比较,差异均有统计学意义(P<0.05),认知功能障碍组患者年龄、CHA2DS2-VASc评分、N端脑钠肽前体(NTproBNP)均高于认知功能正常组患者(P<0.05),认知功能障碍组患者收缩压、LVEF均低于认知功能正常组患者(P<0.05);年龄、受教育程度、LVEF、NTproBNP、CHA2DS2-VASc评分均是影响慢性心力衰竭合并永久性心房颤动患者发生认知功能障碍的独立危险因素(P<0.05);慢性心力衰竭合并永久性心房颤动患者CHA2DS2-VASc评分与LVEF呈负相关(r=-0.417,P=0.000);CHA2DS2-VASc评分,LVEF预测慢性心力衰竭合并永久性心房颤动患者发生认知功能障碍的最佳截断值分别为4分和43%,二者联合的敏感度、特异度和AUC分别为82.43%,96.03%和0.930。结论LVEF和CHA2DS2-VASc评分均是影响慢性心力衰竭合并永久性心房颤动患者发生认知功能障碍的独立危险因素,二者均可作为预测患者发生认知功能障碍的参考指标,且联合预测的价值更高。

HCM Risk-SCD评分单独及联合LVEF对中青年肥厚型心肌病患者长期预后的预测价值

目的:探讨HCM Risk-SCD评分及其联合左心室射血分数(LVEF)预测中青年肥厚型心肌病(HCM)长期预后的价值。方法:收集2014年1月至2022年6月共224例确诊为HCM的中青年患者临床资料。通过Cox回归确定患者发生心源性猝死(SCD)的危险因素,ROC曲线分析LVEF联合HCM Risk-SCD评分对SCD的预测价值。结果:随访期间共发生SCD 17例。在调整了BMI、血小板计数等混杂因素后,HCM Risk-SCD评分对于患者生存结局的评估仍具有统计学意义(HR=1.321,95%CI为1.155~1.510,P<0.001)。HCM Risk-SCD评分与LVEF联合后AUC(95%CI)可达0.901(0.878~0.924),而HCM Risk-SCD评分AUC(95%CI)为0.776(0.762~0.790),LVEF AUC(95%CI)为0.683(0.665~0.701),联合后对HCM患者发生SCD的预测价值上升(P<0.05)。结论:HCM Risk-SCD评分联合LVEF可预测中青年HCM患者发生SCD。

Evaluation of Left Ventricular Function after Percutaneous Recanalization of Chronic Coronary Occlusions: The Role of Two-Dimensional Speckle Tracking Echocardiography

Background: The recanalization of a chronic total coronary occlusion is the possible way to improve left ventricular (LV) function through the recovery of hibernating myocardium. Aim: The aim of this study is to evaluate the role of 2D speckle tracking in evaluation of the left ventricular (LV) systolic function in chronic total occlusion (CTO) patients before and at 1 day as well as 3 months after percutaneous coronary intervention (PCI). Patients and Methods: A prospective observational study included 40 patients diagnosed with coronary angiography to have a chronic total occlusion. Percutaneous coronary revascularization was performed according to standard practices with the femoral approach. Conventional 2D echocardiography was used to assess LV functions and wall motion abnormalities scoring index (WMAI). Using speckle-tracking echocardiography was to measure global longitudinal strain (GLS) and. Follow-up of patients was done at day 1 and 3 months later after PCI. Results: Forty patients were included in this study, with a mean age of 58.55 ± 7.98 years. GLS and WMAI difference at baseline and follow-up shows a positive correlation with left ventricular ejection fraction (LVEF) changes at baseline and follow-up (p Conclusion: The results of this study provide evidence to support the clinical use of 2D-STE to monitor the early changes of LV function. In patients undergoing CTO revascularization, change in GLS was more sensitive predictors for LV function improvement at 3-month follow-up.

CLINICAL RESEARCH ON THE EFFECT OF ACUPUNCTURE ON THE LEFT VENTRICULAR CONTRACTION FUNCTION IN SYMPTOMLESS CARDIAC FAILURE PATIENTS

Objective: To observe the effect of acupuncture therapy on the function of myocardial contraction in symptomless cardiac failure patients.Methods: A total of 60 cases of symptomless cardiac insufficiency inpatients were randomly divided into medication and acupuncture groups, with 30 cases in each group. For patients of acupuncture group, Neiguan (PC 6), Ximen (PC 4), Tanzhong (CV 17), Xinshu (BL 15), Jueyinshu (BL 14) and Geshu (BL 17) were punctured, twice daily, with 30 days being a therapeutic course. In medication group, patients were asked to take Capoten 25 mg (t.i.d.). The left ventricular ejection fraction (LVEF) and its fractional shortening (FS) of the minor axis were used as the indexes for assessing the therapeutic effect and detected by using a color ultrasonic Doppler apparatus. Results: After one course of treatment, of the each 30 cases of acupuncture and medication groups, 13 (43.3%) and 16 (53.3%) had marked improvement, 16 (53.3%) and 14 (46.7%) had improvement, and 1 (3.3%) and 0 had no any effect respectively. No significant difference was found between two groups in the therapeutic effect. It shows acupuncture therapy can improve myocardial contraction function. Conclusion: Acupuncture has a similar effect in enhancing the systolic function of the myocardium.

Change and impact of left ventricular global longitudinal strain during transcatheter aortic valve implantation

BACKGROUND Although transcatheter aortic valve implantation(TAVI)is a safe and effective treatment for aortic stenosis,it still carries some risks,such as valve leaks,stroke,and even death.The left ventricular global longitudinal strain(LVGLS)measurement may be useful for the prediction of adverse events during this operation.AIM To explore the change of LVGLS during TAVI procedure and the relationship between LVGLS and perioperative adverse events.METHODS In this study,61 patients who had undergone percutaneous transfemoral TAVI were evaluated by transthoracic echocardiography.Before surgery,data on left ventricular ejection fraction(LVEF)and LVGLS were collected separately following balloon expansion and stent implantation.Difference in values of LVGLS and LVEF during preoperative balloon expansion(pre-ex),preoperative stent implantation(pre-im)and balloon expansion-stent implantation(ex-im)were also examined.Adverse events were defined as perioperative death,cardiac rupture,heart arrest,moderate or severe perivalvular leakage,significant mitral regurgitation during TAVI,perioperative moderate or severe mitral regurgitation,perioperative left ventricular outflow tract obstruction,reoperation,and acute heart failure.RESULTS The occurrence of perioperative adverse events was associated with differences in pre-ex LVGLS,but not with difference in pre-ex LVEF.There were significant differences between pre-LVGLS and ex-LVGLS,and between pre-LVGLS and im-LVGLS(P=0.037 and P=0.020,respectively).However,differences in LVEF were not significant(P=0.358,P=0.254);however differences in pre-ex LVGLS were associated with pre-LVGLS(P=0.045).Compared to LVEF,LVGLS is more sensitive as a measure of left heart function during TAVI and the perioperative period.Moreover,the differences in LVGLS were associated with the occurrence of perioperative adverse events,and changes in LVGLS were apparent in patients with undesirable LVGLS before the surgery.Furthermore,LVGLS is useful to predict changes in cardiac function during TAVI.CONCLUSION Greater attention should be paid to the patients who plan to undergo TAVI with normal LVEF but poor LVGLS.

Left Atrial Volume Index in Patients with Dilated Cardiomyopathy—Correlation with Left Ventricular Function

Background: The aim of this study was to determine the relation of left atrial (LA) volume and LA volume index with left ventricular function and to determine the association of duration of symptoms and left atrial volume index in patients with dilated cardiomyopathy. Materials and Methods: This was an observational, single centre study conducted in India. A total of 50 patients who were admitted to department of cardiology from July, 2008 to February, 2009 with diagnosis of dilated cardiomyopathy and an ejection fraction of <40% were included. Results: Of the 50 patients, 34 (68%) were males. 27 (54%) patients were in NYHA class II and 23 (46%) patients were in NYHA class III. LA volume was found to be ≥40 ml in all patients. LV function and LA volume were found to be correlated (r = -0.789, p < 0.01). Similarly, there was a correlation between LV function and LA volume index (r = -0.826, p < 0.01). There was no correlation between LA volume index and duration of symptoms (r = 0.04). Conclusion: It can be concluded that there is a strong inverse correlation between LA volume and left ventricular function and also between LA volume index and left ventricular function. The patients with NYHA class III were having larger left atrial volume than those with NYHA class II. Moreover, the duration of symptoms has no correlation with left atrial volume index.

Evaluation of Left Ventricular Systolic Function after Pulmonary Valve Replacement Using Cardiovascular Magnetic Resonance Imaging

Following reparative surgery for tetralogy of Fallot or critical pulmonary stenosis(PS),patients frequently present with severe right ventricular(RV)volume overload due to pulmonary regurgitation,resulting in decreased RV function.Surgical pulmonary valve replacement(PVR)is known to improve RV function,but changes in left ventricular(LV)function after PVR have rarely been described.We sought to determine the midterm results regarding LV systolic function after PVR using cardiac MRI in 40 consecutive patients with repaired TOF(31 patients)or PS(9 patients)with an age of 29±9 years who underwent PVR from 2006 to 2011 at a single center.Cardiac MRI RV and LV volumes before and after PVR were analyzed.Demographics,clinical variables,cardiopulmonary bypass duration,and medications were reviewed.LV ejection fraction(LVEF)increased from(54±8)to(57±6)%(P=0.02).Before PVR,26 patients had depressed LVEF of(49±5)%(range 36– 54%).In this group,LVEF increased by(7±7)%(P<0.0001)after PVR.Low LVEF before PVR was correlated with increased LVEF after PVR(regression coefficient-0.7,R 2=0.59,P<0.0001).Demographics,medications,prior pregnancies,and cardiopulmonary bypass duration had no effect on LVEF after PVR.The increase in LVEF was most significant in patients with low pre-PVR LVEF.

Heart failure with preserved ejection fraction: A distinct heart failure phenotype?

The present work discusses the serious confusion resulting from the arbitrary nomenclature of heart failure with preserved ejection fraction(HFpEF),the presumed underlying pathophysiology,and the supposed features.A consequence of this misconception is that HFpEF trials have recruited patients with entirely different characteristics rendering the extrapolation of the results of one study to the other infeasible and dramatically affecting diagnosis and treatment.

Left Ventricular Dysfunction: The Perspective of Echocardiography in Ghana

Introduction: Ghana is one of the fastest growing economies in sub-Saharan Africa which is expected to undergo a significant epidemiologic transition because of industrialisation and economic development. Having transitioned from low to middle income status recently, this study investigated the epidemiology of left ventricular dysfunction (LVD) in patients who were referred for echocardiography. Material and Methods: We conducted a retrospective cross-sectional study on an out-patient population who were referred to the Precise Specialist Clinic in Kumasi, Ghana for echocardiography, from January 2016 to December 2018. Descriptive statistical analyses were performed and the results summarised in the proportions, tables and pie charts. Categorical variables and proportions were compared using Fisher’s exact test and test of proportions respectively. P-value Results: The results show that 61% of the out-patient population referred for echocardiography between 2016 and 2018 had LVD at a mean age of 59 years. In this LVD population, Heart Failure with preserved ejection fraction (HFpEF) and Heart Failure with reduced ejection fraction (HFrEF) accounted for 73% and 27% respectively. The majority of patients with HFrEF also had left ventricular diastolic dysfunction, mitral regurgitation and tricuspid regurgitation.Conclusion: This study shows that, HFpEF was seen in over 70% of patients with LVD, and it occurred at a relatively younger age. Efforts should be made for prevention, early detection and control of conditions such as hypertension, diabetes and obesity which have been shown to be associated with HFpEF.

Impact of severe left ventricular dysfunction on mid-term mortality in elderly patients undergoing transcatheter aortic valve implantation

有减少的左室的功能的 BackgroundWhether 病人在大动脉的阀门培植(TAVI ) 是的 transcatheter 以后介绍更坏的结果争论。这研究的目的是估计基线的影响严重的在有大动脉的狭窄的 TAVI.MethodsSix-hundred-forty-nine 病人后面的死亡上的左室的喷射部分(LVEF ) 的缺陷与 CoreValve 系统(92.8%) 或爱德华兹智慧阀门系统(7.2%) 经历了 TAVI。基线 LVEF 被 echocardiographic Simpson 方法测量。LVEF ≤ 的影响；30% 被考克斯 regression.ResultsPatients 与 LVEF ≤ 在死亡上估计；30%(n = 63 ) ，作为与那些相比与 LVEF >；30%(n = 586 ) ，有 NHYA 班 > 的更高的流行；2 (P <；0.001 ) 并且与更高的 Euroscore 介绍了(P <；0.001 ) 。程序的成功在两个组是类似的(98.4% 对 97.2% ， P = 1 ) 。在 436 天的中部的后续以后(25 th -75 th 百分位数， 357-737 天) ，所有原因死亡[23.8% 对 23.7% ， P = 0.87，危险比率(HR ) ：0.96， 95% 信心间隔(CI ) ：0.56-1.63 ] 并且心脏的死亡(19.1% 对 17.6% ， P = 0.89， HR：1.04， 95% CI：0.57-1.90 ) 在有 LVEF ≤ 的病人是类似的；30% 作为与那些相比与 LVEF >；30% 。三十天的所有原因死亡不在二个组之间是显著地不同的(11.1% 对 6.3% ， P = 0.14， HR：1.81， 95% CI：0.81-4.06 ) 。有 LVEF ≤ 的病人；30% 向 30 天的心脏的死亡的更高的风险有一个趋势(11.1% 对 5.3% ；P = 0.06， HR：2.16， 95% CI：0.95-4.90 ) ，它消失在 multivariable 调整以后(P = 0.22 ).ConclusionsBaseline LVEF 的严重缺陷不是一个预言者在 TAVI 以后增加了短期、中间的死亡。有左室的功能的严重缺陷的选择病人不应该被拒绝 TAVI。

冠状动脉溶栓及早期PCI术后LVEF变化规律及对预后的影响

目的探讨左室射血分数(LVEF)指标和急性ST段抬高型心肌梗死(STEMI)患者冠状动脉溶栓及经皮冠状动脉介入(PCI)治疗预后的关系。方法选取本院2018年3月—2021年3月发病12 h内冠状动脉溶栓和进行PCI手术的140例STEMI患者作为研究对象,根据冠状动脉溶栓及PCI手术后是否发生主要不良心血管事件(MACE)将其分为预后不良组(58例)和预后良好组(82例)。比较两组患者的一般资料,利用多因素Logistic回归方法分析患者产生预后不良的因素,绘制相关的列线图模型并评价。结果年龄、慢性阻塞性肺疾病、N端B型脑钠肽前体(NT-proBNP)、C反应蛋白(CRP)、LVEF、肌钙蛋白(TnI)、血肌酐(Scr)与STEMI具有密切相关性,其中年龄、慢性阻塞性肺疾病、NT-proBNP、CRP、TnI、Scr均为STEMI发生的独立危险因素(P<0.05),LVEF为STEMI发生的独立保护因素(P<0.05)。结论本研究建立的列线图模型能有效预测STEMI患者冠状动脉溶栓及PCI术预后情况,临床上应加强对LVEF水平的监护,提高患者LVEF水平。

重组人脑利钠肽联合左西孟旦治疗重症脓毒症心肌病患者的效果及对LVEF、LVEDD水平的影响

目的探讨重症脓毒症心肌病患者选择重组人脑利钠肽联合左西孟旦的治疗效果及对患者心功能指标[左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)]水平的影响。方法100例重症脓毒症心肌病患者,运用单双数字表分组方式分为对照组和实验组,每组50例。对照组选择重组人脑利钠肽治疗,实验组在对照组基础上联合左西孟旦治疗。对比两组患者的治疗效果,治疗前后的LVEF、LVEDD水平,用药后不良反应发生情况。结果实验组治疗总有效率为96.00%,高于对照组的82.00%,差异具有统计学意义(P<0.05)。实验组治疗前、治疗后24 h、治疗后48 h、治疗后72 h的LVEF分别为(31.37±4.13)%、(42.63±5.05)%、(43.22±5.88)%、(55.37±5.03)%,对照组分别为(31.22±4.03)%、(31.28±4.05)%、(36.63±3.23)%、(42.63±5.05)%。实验组治疗前、治疗后24 h、治疗后48 h、治疗后72 h的LVEDD分别为(62.52±4.13)、(60.28±2.05)、(55.13±0.32)、(50.28±4.05)mm,对照组分别为(62.33±4.05)、(60.32±2.05)、(55.28±4.05)、(51.28±3.05)mm。实验组治疗后24、48、72 h的LVEF均高于本组治疗前,对照组治疗后48、72 h的LVEF均高于本组治疗前,差异具有统计学意义(P<0.05)。两组治疗后24、48、72 h的LVEDD均小于本组治疗前,差异具有统计学意义(P<0.05)。实验组治疗后24、48、72 h的LVEF均高于对照组,差异具有统计学意义(P<0.05)。实验组用药后的不良反应发生率为4.00%,低于对照组的16.00%,差异具有统计学意义(P<0.05)。结论重症脓毒症心肌病患者选择重组人脑利钠肽联合左西孟旦治疗可显著改善患者的心脏参数,降低药物不良反应发生率,提升疾病治疗效果。

三种剂量沙库巴曲缬沙坦片联合美托洛尔治疗LVEF<40%心力衰竭的疗效观察

目的:探究三种剂量沙库巴曲缬沙坦片联合美托洛尔治疗左室射血分数(LVEF)<40%心力衰竭的疗效。方法:从东莞厚街仁康医院抽取2021年2月—2022年7月时间段内入院诊疗的LVEF<40%心力衰竭患者90例,即LVEF降低性心衰(HFrEF)患者,据沙库巴曲缬沙坦片给药剂量分为3个组别,即低剂量组(n=30)、中剂量组(n=30)、高剂量组(n=30)。90例患者入院均接受对症支持治疗,并给药美托洛尔,其中沙库巴曲缬沙坦片给药剂量:低剂量组50mg、中剂量组100mg、高剂量组200mg。持续治疗12周,比较治疗前后LVEF及心脏重构指标左室后壁厚度(LVPWT)、室间隔厚度(IVST)及左心室质量指数(LVMI);临床疗效及药物不良反应情况。结果:治疗后高剂量组LVEF及心脏重构指标LVPWT、IVST、LVMI较中剂量组、低剂量组改善幅度大,且中剂量组较低剂量组改善幅度大(P<0.05);高剂量组临床疗效有效率高于中剂量组与低剂量组,且中剂量组高于低剂量组(P<0.05)。高剂量组药物不良反应发生率高于中剂量组与低剂量组(P<0.05),而中剂量组与低剂量组间比较无差异(P>0.05)。结论:高剂量沙库巴曲缬沙坦的疗效优于中剂量及低剂量,左室射血分数及心脏重构指标改善幅度最大,但高剂量组药物不良反应多,临床用药时需多加关注。