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左心室逆重构作为解决左心室血栓的有前途的策略。

Left ventricular reverse remodelling as a promising strategy for resolving left ventricular thrombus.

机构信息

Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China.

College of Pharmacy, Dalian Medical University, Dalian, China.

出版信息

ESC Heart Fail. 2024 Aug;11(4):2214-2222. doi: 10.1002/ehf2.14781. Epub 2024 Apr 16.

DOI:10.1002/ehf2.14781
PMID:38628024
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11287347/
Abstract

AIMS

Recent years, several studies have suggested that abnormal baseline left ventricular (LV) function and structure are associated with left ventricular thrombus (LVT) formation. Despite this, most studies have given less attention to the potential role of left ventricular reverse remodelling (LVRR), that is, the improvement of LV function and structure, in resolving LVT. In this study, we aim to investigate the clinical characteristics, prognosis, and LVT resolution in patients with LVRR.

METHODS AND RESULTS

This is a retrospective study conducted at The First Affiliated Hospital of Dalian Medical University. Our cohort consists of patients diagnosed with LVT between 1 November 2015 and 31 May 2020. Enrolled patients were categorized into two groups: LVRR and Failure of LVRR. The primary endpoints included LVT resolution and embolic events. A total of 84 patients were included in the study, with 59 patients in the LVRR group and 25 patients in the Failure of LVRR group. In our study, patients in the LVRR group experienced higher incidence of LVT resolution and a lower risk of embolic events. Multivariate logistic analysis revealed that Failure of LVRR was the only independent negative predictor for LVT resolution and positive predictor for embolic events.

CONCLUSIONS

Patients with LVRR experience higher incidence of LVT resolution and have lower risk of embolic events, highlighting the significance of identifying and mitigating risk factors that contribute to abnormal LV function and structure in management of patients with LVT.

摘要

目的

近年来,多项研究表明,异常的左心室(LV)基线功能和结构与左心室血栓(LVT)形成有关。尽管如此,大多数研究对左心室逆重构(LVRR)的潜在作用关注较少,即 LV 功能和结构的改善,在解决 LVT 方面的作用。本研究旨在探讨 LVRR 患者的临床特征、预后和 LVT 消退情况。

方法和结果

这是一项在大连医科大学附属第一医院进行的回顾性研究。我们的队列包括 2015 年 11 月 1 日至 2020 年 5 月 31 日期间诊断为 LVT 的患者。纳入的患者分为两组:LVRR 和 LVRR 失败。主要终点包括 LVT 消退和栓塞事件。共纳入 84 例患者,其中 LVRR 组 59 例,LVRR 失败组 25 例。在我们的研究中,LVRR 组患者的 LVT 消退发生率更高,栓塞事件风险更低。多变量逻辑分析显示,LVRR 失败是 LVT 消退的唯一独立负预测因子,也是栓塞事件的独立正预测因子。

结论

LVRR 患者的 LVT 消退发生率更高,栓塞事件风险更低,这强调了在 LVT 患者管理中,识别和减轻导致 LV 功能和结构异常的危险因素的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41cd/11287347/b6e7f86b7dc1/EHF2-11-2214-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41cd/11287347/6067be43e933/EHF2-11-2214-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41cd/11287347/5a21c0ac2db9/EHF2-11-2214-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41cd/11287347/c2beb8073380/EHF2-11-2214-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41cd/11287347/b6e7f86b7dc1/EHF2-11-2214-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41cd/11287347/6067be43e933/EHF2-11-2214-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41cd/11287347/5a21c0ac2db9/EHF2-11-2214-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41cd/11287347/c2beb8073380/EHF2-11-2214-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41cd/11287347/b6e7f86b7dc1/EHF2-11-2214-g001.jpg

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