New York, NY (November 04, 2021) Kugwiritsa ntchito njira yatsopano yotchedwa quantitative flow ratio (QFR) kudziwa bwino komanso kuyeza kuopsa kwa kutsekeka kwa mtsempha wamagazi kumatha kubweretsa zotsatira zabwino kwambiri pambuyo pa percutaneous coronary intervention (PCI), malinga ndi a maphunziro atsopano opangidwa mogwirizana ndi a Mount Sinai faculty.
Kafukufukuyu, yemwe ndi woyamba kusanthula QFR ndi zotsatira zake zachipatala, angapangitse kufalikira kwa QFR monga njira ina ya angiography kapena mawaya opanikizika kuti athe kuyeza kuopsa kwa blockages, kapena zilonda, kwa odwala omwe ali ndi matenda a mitsempha ya mitsempha.Zotsatira za kafukufukuyu zidalengezedwa Lachinayi, Novembara 4, ngati kuyesa kwachipatala mochedwa ku Transcatheter Cardiovascular Therapeutics Conference (TCT 2021), ndipo idasindikizidwanso mu The Lancet.
"Kwa nthawi yoyamba timakhala ndi chidziwitso chachipatala kuti kusankha zilonda ndi njira iyi kumapangitsa kuti odwala omwe ali ndi matenda a mitsempha ya m'mitsempha alandire chithandizo chamankhwala," anatero Gregg W. Stone, MD, Director of Academic Affairs for Mount Sinai Health System ndi Pulofesa. Medicine (Cardiology), ndi Population Health and Policy, ku Icahn School of Medicine ku Mount Sinai."Popewa nthawi, zovuta, ndi zina zowonjezera zomwe zimafunikira kuyeza kukula kwa zilonda pogwiritsa ntchito waya wopanikizika, njira yosavutayi iyenera kukulitsa kwambiri kugwiritsa ntchito physiology kwa odwala omwe akudwala catheterization yamtima."
Odwala omwe ali ndi matenda a mitsempha ya m'mitsempha-mitsempha ya mitsempha yomwe imayambitsa kupweteka pachifuwa, kupuma pang'ono, ndi matenda a mtima-nthawi zambiri amakumana ndi PCI, njira yopanda opaleshoni yomwe akatswiri a cardiologists amagwiritsa ntchito catheter kuti aike stents m'mitsempha yotsekedwa. Mitsempha yobwezeretsa magazi.
Madokotala ambiri amadalira angiography ( X-ray of the coronary arteries ) kuti adziwe kuti ndi mitsempha iti yomwe ili ndi zotchinga kwambiri, ndipo amagwiritsa ntchito chithunzithunzi chimenecho kuti asankhe mitsempha yomwe ikuyenera kuchiza.Njira iyi si yangwiro: zotchinga zina zimatha kuwoneka mokulirapo kapena zocheperapo kuposa momwe zilili ndipo madotolo sangathe kudziwa ndendende kuchokera ku angiogram yokha kuti ndi zotchinga ziti zomwe zimasokoneza kwambiri kuyenda kwa magazi.Zotsatira zimatha kukhala bwino ngati zotupa zokhala ndi stent zasankhidwa pogwiritsa ntchito waya wokakamiza kuti azindikire zomwe zikulepheretsa kutuluka kwa magazi.Koma kuyeza kumeneku kumatenga nthawi, kungayambitse zovuta, ndipo kumaphatikizapo ndalama zowonjezera.
Ukadaulo wa QFR umagwiritsa ntchito kukonzanso kwa mtsempha wa 3D ndikuyezera kuthamanga kwa magazi komwe kumapereka miyeso yolondola ya kutsika kwa kuthamanga kwapakatikati, zomwe zimalola madokotala kupanga zisankho zabwinoko za mitsempha yomwe imayenera kutsika pa PCI.
Kuti aphunzire momwe QFR imakhudzira zotsatira za odwala, ofufuza adachita mayeso apakati, osasinthika, akhungu a anthu 3,825 ku China omwe akukumana ndi PCI pakati pa Disembala 25, 2018, ndi Januware 19, 2020. Odwala mwina anali ndi vuto la mtima maola 72 asanachitike, kapena anali ndi mtsempha umodzi wapamtima wokhala ndi chotchinga chimodzi kapena zingapo zomwe angiogram anayeza kuti pakati pa 50 ndi 90 peresenti inachepera.Theka la odwalawo adakhala ndi ndondomeko yoyendetsera angiography pogwiritsa ntchito kuwunika kowonekera, pamene theka lina linapanga njira yotsogoleredwa ndi QFR.
Mu gulu lotsogozedwa ndi QFR, madokotala adasankha kuti asagwiritse ntchito zombo za 375 zomwe poyamba zinapangidwira PCI, poyerekeza ndi 100 mu gulu lotsogolera angiography.Tekinolojeyi idathandizira kuthetsa kuchuluka kwa ma stenti osafunika.Mu gulu la QFR, madokotala adachitiranso ziwiya za 85 zomwe sizinapangidwe kuti zikhale ndi PCI poyerekeza ndi 28 mu gulu lotsogolera angiography.Tekinolojeyi idazindikira zilonda zotsekereza zomwe sizikanachiritsidwa.
Zotsatira zake, odwala omwe ali mu gulu la QFR anali ndi chiwerengero chochepa cha chaka chimodzi cha matenda a mtima poyerekeza ndi gulu la angiography-okha (odwala 65 vs. 109 odwala) komanso mwayi wochepa wofuna PCI yowonjezera (odwala 38 vs. 59 odwala) kupulumuka kofanana.Pa chizindikiro cha chaka chimodzi, 5.8 peresenti ya odwala omwe amathandizidwa ndi njira ya PCI yotsogoleredwa ndi QFR anali atamwalira, anali ndi vuto la mtima, kapena ankafunika kubwereza revascularization (stenting), poyerekeza ndi 8.8 peresenti ya odwala omwe amatsatira ndondomeko ya PCI yoyendetsedwa ndi angiography. , kuchepetsedwa ndi 35 peresenti.Ofufuzawa adanena kuti kusintha kwakukulu kumeneku kwa zotsatira za QFR kulola madokotala kusankha zombo zolondola za PCI komanso kupewa njira zosafunikira.
"Zotsatira za kuyesedwa kosasinthika kwakukulu kumeneku ndizothandiza kwambiri, ndipo zofanana ndi zomwe zikanayembekezeredwa ndi chitsogozo cha PCI chotengera waya.Kutengera zomwe zapezazi, kutsatira kuvomerezedwa ndiulamuliro ndikuyembekeza kuti QFR ilandilidwa kwambiri ndi akatswiri azamtima kuti athandizire odwala awo. ”adatero Dr Stone.
Tags: Matenda a Aortic ndi Opaleshoni, Mtima - Cardiology & Cardiovascular Surgery, Icahn School of Medicine ku Mount Sinai, Mount Sinai Health System, Odwala, Gregg Stone, MD,FACC, FSCAI, ResearchZa Mount Sinai Health System
Mount Sinai Health System ndi imodzi mwazinthu zazikulu kwambiri zachipatala mumzinda wa New York, wokhala ndi antchito opitilira 43,000 omwe amagwira ntchito m'zipatala zisanu ndi zitatu, opitilira 400 akuchipatala, pafupifupi ma lab 300, sukulu ya unamwino, komanso sukulu yotsogola yazamankhwala ndi maphunziro. maphunziro omaliza.Phiri la Sinai limapititsa patsogolo thanzi la anthu onse, kulikonse, mwa kutenga zovuta zachipatala zovuta kwambiri za nthawi yathu - kupeza ndi kugwiritsa ntchito maphunziro atsopano a sayansi ndi chidziwitso;kupanga mankhwala otetezeka, ogwira mtima;kuphunzitsa mbadwo wotsatira wa atsogoleri azachipatala ndi oyambitsa;ndikuthandizira madera akumidzi popereka chisamaliro chapamwamba kwa onse omwe akuchifuna.
Kupyolera mu kuphatikizika kwa zipatala zake, ma lab, ndi masukulu, Phiri la Sinai limapereka mayankho okwanira azaumoyo kuyambira pakubadwa kudzera muzachipatala, kugwiritsa ntchito njira zotsogola monga luntha lochita kupanga komanso chidziwitso ndikusunga zosowa zachipatala ndi malingaliro a odwala pakati pa chithandizo chonse.The Health System imaphatikizapo madokotala pafupifupi 7,300 oyambirira ndi apadera;Malo 13 opangira opareshoni ogwirizana m'maboma onse asanu a New York City, Westchester, Long Island, ndi Florida;komanso zipatala zopitilira 30 zomwe zimagwirizana ndi anthu ammudzi.Timayikidwa nthawi zonse ndi US News & World Report's Best Hospitals, kulandira udindo wapamwamba wa "Honor Roll", ndipo ndife apamwamba kwambiri: No. 1 mu Geriatrics ndi pamwamba 20 mu Cardiology / Heart Surgery, Diabetes / Endocrinology, Gastroenterology / GI Surgery, Neurology /Neurosurgery, Orthopedics, Pulmonology/Mapapo Opaleshoni, Rehabilitation, ndi Urology.New York Eye and Ear Infirmary ya Mount Sinai ili pa nambala 12 mu Ophthalmology."Zipatala Zabwino Kwambiri Za Ana" za US News & World Report zakhala zipatala za Mount Sinai Kravis Children's Hospital pakati pazipatala zabwino kwambiri za ana mdziko muno.
Nthawi yotumiza: Nov-10-2023