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在急性冠状动脉综合征患者中使用便携式经胸超声心动图筛查腹主动脉瘤

Screening of Abdominal Aortic Aneurysm Using Portable Transthoracic Echocardiography among Patients with Acute Coronary Syndrome.

作者信息

Shukha Yousef, Koren Ofir, Or Tsafrir, Turgeman Yoav, Mahamid Mahmud, Jabaren Mohamed

机构信息

Internal Medicine Department E, Rambam Medical Center, Haifa, Israel.

Heart Institute, Emek Medical Center, Afula, Israel.

出版信息

Cardiol Res Pract. 2020 Jun 27;2020:9510546. doi: 10.1155/2020/9510546. eCollection 2020.

Abstract

BACKGROUND

Abdominal aortic aneurysm (AAA) and acute coronary syndrome (ACS) share common risk factors.

OBJECTIVES

To assess the abdominal aortic diameter (AAD) among patients with ACS using transthoracic echocardiography (TTE).

METHODS

Patients with ACS admitted to our intensive cardiac care unit from December 2013 to June 2014 were screened prospectively for AAA via AAD measurement in the subcostal TTE view. AAA was defined as an aneurysm with a transverse diameter of ≥30 mm.

RESULTS

Sixty seven patients were included. The male-to-female sex ratio was 7 : 1. The vast majority of patients were admitted due to STEMI (73%), and the rest were equally divided as NSTEMI and unstable angina. The mean patient age was 58.4 ± 10.4 years. AAD measurements were feasible in 57 patients (85%); among them, AAA was diagnosed in six patients (10.5%). The average additional time required to measure the abdominal aorta was 4 ± 1 min. All patients with AAA were men and had a higher prevalence of smoking (83.3% vs. 60.6%, < 0.003) and a lower incidence of diabetes mellitus than those without aneurysm. The prevalence of AAA tended to be related to age (12.5% in those older than 60 years and 18.7% in those older than 65 years).

CONCLUSIONS

The overall prevalence of AAA is significantly high among patients with ACS and increases with age. AAA screening as a part of routine cardiac TTE can be easily, rapidly, and feasibly performed and yield accurate findings. AAD measurement in the subcostal view should be implemented as a part of routine TTE in patients with ACS.

摘要

背景

腹主动脉瘤(AAA)与急性冠状动脉综合征(ACS)有共同的危险因素。

目的

采用经胸超声心动图(TTE)评估ACS患者的腹主动脉直径(AAD)。

方法

对2013年12月至2014年6月入住我院重症心脏监护病房的ACS患者,通过肋下TTE视图测量AAD,对AAA进行前瞻性筛查。AAA定义为横径≥30 mm的动脉瘤。

结果

纳入67例患者。男女比例为7∶1。绝大多数患者因ST段抬高型心肌梗死(STEMI)入院(73%),其余患者非ST段抬高型心肌梗死(NSTEMI)和不稳定型心绞痛各占一半。患者平均年龄为58.4±10.4岁。57例患者(85%)可行AAD测量;其中6例患者(10.5%)诊断为AAA。测量腹主动脉平均额外需要4±1分钟。所有AAA患者均为男性,吸烟患病率较高(83.3%对60.6%,P<0.003),糖尿病发病率低于无动脉瘤患者。AAA患病率倾向于与年龄相关(60岁以上患者中为12.5%,65岁以上患者中为18.7%)。

结论

ACS患者中AAA总体患病率显著较高,且随年龄增加。作为常规心脏TTE的一部分,AAA筛查可轻松、快速且可行地进行,并能得出准确结果。肋下视图AAD测量应作为ACS患者常规TTE的一部分实施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b93/7336210/025c6a551bc9/CRP2020-9510546.001.jpg

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