Zavar Reihaneh, Soleimani Azam, Tajmirriahi Marzieh, Amirpour Afshin, Mahmoudiandehcordi Shaghayegh, Farhang Faezeh
Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
ARYA Atheroscler. 2024 Jan-Feb;20(1):62-71. doi: 10.48305/arya.2023.42244.2927.
The current systematic review and pooled analysis were conducted to answer several questions using findings from case reports and case series as follows: (1) Demographic characteristics; (2) clinical findings; (3) management approach; and (4) prognosis of individuals diagnosed with intramyocardial dissecting hematoma.
Electronic databases, including PubMed (Medline), Scopus, and Web of Science, were systematically searched from the earliest available date up to February 2023 using selected keywords. All analyses were performed using SPSS software version 27 (IBM Corp, Armonk, NY, USA), and a P-value less than 0.05 was considered statistically significant.
A total of 77 patients diagnosed with Intramyocardial dissecting hematoma (IDH) comprised the study population, with a mean (standard deviation) age of 58.72 (13.99) years, of which 22.1% were women. Patients of higher age experienced a higher risk for mortality compared to younger subjects (OR=1.05, 95% CI: 1.01, 1.10; P=0.014). In addition, the implementation of angiography (OR=0.25, 95% CI: 0.08, 0.71; P=0.010) and cardiac magnetic resonance (OR=0.19, 95% CI: 0.06, 0.60; P=0.004) in the context of diagnosis reduced the risk of death compared to those who did not receive these interventions. Similarly, the diagnosis of pericardial effusion significantly increased the risk of mortality compared to those without pericardial effusion (OR=3.92, 95% CI: 1.27, 12.07; P=0.017).
The authors found that older patients experience a poor prognosis compared to younger ones. In addition, the utilization of angiography and cardiac magnetic resonance improves the prognosis of individuals. Likewise, the diagnosis of pericardial effusion in patients with IDH increases the odds of mortality.
本系统评价和汇总分析旨在利用病例报告和病例系列研究结果回答以下几个问题：（1）人口统计学特征；（2）临床表现；（3）治疗方法；（4）诊断为心肌内夹层血肿患者的预后。
使用选定的关键词，对电子数据库进行系统检索，包括PubMed（Medline）、Scopus和Web of Science，检索时间从最早可用日期至2023年2月。所有分析均使用SPSS 27软件（美国纽约州阿蒙克市IBM公司）进行，P值小于0.05被认为具有统计学意义。
共有77例诊断为心肌内夹层血肿（IDH）的患者纳入研究人群，平均（标准差）年龄为58.72（13.99）岁，其中22.1%为女性。与年轻患者相比，年龄较大的患者死亡风险更高（OR=1.05，95%CI：1.01，1.10；P=0.014）。此外，在诊断时进行血管造影（OR=0.25，95%CI：0.08，0.71；P=0.010）和心脏磁共振成像（OR=0.19，95%CI：0.06，0.60；P=0.004）与未接受这些干预措施的患者相比，降低了死亡风险。同样，与无心包积液的患者相比，心包积液的诊断显著增加了死亡风险（OR=3.92，95%CI：1.27，12.07；P=0.017）。
作者发现，与年轻患者相比，老年患者预后较差。此外，血管造影和心脏磁共振成像的应用可改善患者的预后。同样，IDH患者心包积液的诊断增加了死亡几率。
