I-New York, NY (Novemba 04, 2021) Ukusetshenziswa kwendlela yenoveli ebizwa ngokuthi i-quantitative flow ratio (QFR) ukuhlonza ngokunembile kanye nokukala ubulukhuni bokuvinjwa komthambo kungaholela emiphumeleni ethuthuke kakhulu ngemuva kokungenelela kwe-percutaneous coronary intervention (PCI), ngokusho kombiko. ucwaningo olusha olwenziwe ngokubambisana ne-Mount Sinai faculty.
Lolu cwaningo, olungowokuqala ukuhlaziya i-QFR kanye nemiphumela yomtholampilo ehlobene nayo, lungase luholele ekwamukelweni okubanzi kwe-QFR njengenye indlela ye-angiography noma izintambo zokucindezela ukuze kulinganiswe ubunzima bokuvinjwa, noma izilonda, ezigulini ezinesifo se-coronary artery.Imiphumela yocwaningo imenyezelwe ngoLwesine, Novemba 4, njengesivivinyo somtholampilo esiphuke sekwephuzile eNgqungqutheleni ye-Transcatheter Cardiovascular Therapeutics (TCT 2021), futhi yashicilelwa ngasikhathi sinye kuThe Lancet.
"Ngokokuqala ngqa sinokuqinisekiswa komtholampilo ukuthi ukukhethwa kwesilonda ngale ndlela kuthuthukisa imiphumela yeziguli ezine-coronary artery disease ezithola ukwelashwa kwe-stent," kusho umlobi ophezulu u-Gregg W. Stone, MD, uMqondisi Wezindaba Zezemfundo we-Mount Sinai Health System kanye noProfesa we Imithi (I-Cardiology), kanye Nezempilo Nenqubomgomo Yabantu, e-Icahn School of Medicine eNtabeni iSinayi."Ngokugwema isikhathi, izinkinga, kanye nezinsiza ezengeziwe ezidingekayo ukuze kulinganiswe ubunzima bezilonda usebenzisa ucingo lokucindezela, le ndlela elula kufanele ikhulise kakhulu ukusetshenziswa kwe-physiology ezigulini eziqhutshwa izinqubo ze-catheterization yenhliziyo."
Iziguli ezine-coronary artery disease-ukwakheka kwe-plaque ngaphakathi kwemithambo eholela ebuhlungu besifuba, ukuphefumula, nokuhlasela kwenhliziyo-ngokuvamile zithola i-PCI, inqubo engeyona yokuhlinzwa lapho izazi zenhliziyo ezingenelayo zisebenzisa i-catheter ukubeka ama-stents ku-coronary evinjiwe. imithambo ukubuyisela ukugeleza kwegazi.
Odokotela abaningi bancike ku-angiography (i-X-ray yemithambo yenhliziyo) ukuze banqume ukuthi yimiphi imithambo evaleke kakhulu, futhi basebenzise lokho kuhlola okubonakalayo ukuze banqume ukuthi yimiphi imithambo okufanele yelashwe.Le ndlela ayiphelele: okunye ukuvinjwa kungase kubukeke kubi kakhulu noma kuncane kakhulu kunalokho okuyikho futhi odokotela abakwazi ukusho ngokuqondile nge-angiogram iyodwa ukuthi yikuphi ukuvinjwa okuthinta kabi ukugeleza kwegazi.Imiphumela ingathuthukiswa uma izilonda ezenza i-stent zikhethwa kusetshenziswa ucingo lokucindezela ukuze kuhlonzwe ukuthi yiziphi ezivimbela ukugeleza kwegazi.Kodwa le nqubo yokulinganisa ithatha isikhathi, ingabangela izinkinga, futhi ihilele izindleko ezengeziwe.
Ubuchwepheshe be-QFR busebenzisa ukwakhiwa kabusha komthambo we-3D kanye nokukalwa kwesivinini sokugeleza kwegazi okunikeza izilinganiso ezinembile zokwehla kwengcindezi endaweni evalekile, okuvumela odokotela ukuba benze izinqumo ezingcono zokuthi imiphi imithambo yokugoba ngesikhathi se-PCI.
Ukuze batadishe ukuthi i-QFR iyithinta kanjani imiphumela yesiguli, abacwaningi benze isivivinyo esigxile ezintweni eziningi, esingahleliwe, esiphuphuthekile sabahlanganyeli abangu-3,825 e-China abathola i-PCI phakathi komhla zingama-25 Disemba 2018, noJanuwari 19, 2020. Iziguli kungenzeka zibe nesifo senhliziyo emahoreni angu-72 ngaphambili, noma yayinomshini okungenani owodwa we-coronary ovalekile okukodwa noma ngaphezulu i-angiogram ekala yaba phakathi kwamaphesenti angama-50 nangama-90 ancipha.Ingxenye yeziguli yenze inqubo evamile eqondiswa i-angiography esekelwe ekuhloleni okubonakalayo, kuyilapho enye ithole isu eliqondiswa yi-QFR.
Eqenjini eliqondiswa i-QFR, odokotela bakhetha ukungayiphathi imikhumbi ye-375 eyayihloselwe i-PCI ekuqaleni, uma kuqhathaniswa ne-100 eqenjini eliqondiswa i-angiography.Ngakho ubuchwepheshe busize ekuqedeni inani elikhulu lama-stents angadingekile.Eqenjini le-QFR, odokotela baphinde baphatha izitsha ze-85 ezazingahloselwe i-PCI ekuqaleni uma kuqhathaniswa ne-28 eqenjini eliqondiswa yi-angiography.Ngaleyo ndlela ubuchwepheshe buhlonze izilonda ezivimbayo ebezingeke zelashwe.
Ngenxa yalokho, iziguli eqenjini le-QFR zinezinga eliphansi lonyaka owodwa wokuhlaselwa yinhliziyo uma kuqhathaniswa neqembu le-angiography kuphela (iziguli ezingu-65 ngokumelene neziguli ze-109) kanye nethuba elincane lokudinga i-PCI eyengeziwe (iziguli ze-38 vs. ukusinda okufanayo.Esikhathini sonyaka owodwa, amaphesenti angu-5.8 eziguli eziphathwe ngenqubo ye-PCI eqondiswa i-QFR ayekade efile, enesifo senhliziyo, noma edinga ukuphindaphinda i-revascularization (stenting), uma kuqhathaniswa namaphesenti angu-8.8 eziguli ezithatha inqubo ye-PCI eqondiswa i-angiography. , ukuncishiswa ngamaphesenti angu-35.Abacwaningi bathi lokhu kuthuthukiswa okuphawulekayo kwemiphumela ku-QFR evumela odokotela ukuthi bakhethe imikhumbi efanele ye-PCI futhi bagweme izinqubo ezingadingekile.
“Imiphumela yalolu hlolo olukhulu oluphuphuthekiswe okungahleliwe inenjongo ngokomtholampilo, futhi ifana nalokho obekungalindeleka ngokuqondiswa kwe-PCI okusekelwe ocingweni.Ngokusekelwe kulokhu okutholakele, ngokulandela ukugunyazwa kokulawula ngingalindela ukuthi i-QFR yamukelwe kabanzi odokotela benhliziyo abangenelele ukuze bathuthukise imiphumela yeziguli zabo. "Kusho uDkt Stone.
Amathegi: Izifo ze-Aortic kanye Nokuhlinzwa, Inhliziyo – I-Cardiology & Cardiovascular Surgery, I-Icahn School of Medicine eNtabeni iSinayi, I-Mount Sinai Health System, Ukunakekelwa Kwesiguli, Gregg Stone, MD,FACC, FSCAI, UcwaningoMayelana ne-Mount Sinai Health System
I-Mount Sinai Health System ingenye yezinhlelo zezokwelapha ezinkulu kunazo zonke endaweni kamasipala wedolobha laseNew York, inabasebenzi abangaphezu kuka-43,000 abasebenza ezibhedlela eziyisishiyagalombili, iziguli ezingaphezu kuka-400, amalebhu acishe abe ngu-300, isikole sabahlengikazi, kanye nesikole esihamba phambili sezokwelapha imfundo eneziqu.INtaba iSinayi ithuthukisa impilo yabo bonke abantu, yonke indawo, ngokuthatha izinselele zokunakekelwa kwezempilo eziyinkimbinkimbi kakhulu zesikhathi sethu - ukuthola nokusebenzisa ukufunda nolwazi olusha lwesayensi;ukuthuthukisa izindlela zokwelapha eziphephile nezisebenza ngempumelelo;ukufundisa isizukulwane esilandelayo sabaholi bezokwelapha kanye nabasunguli;kanye nokweseka imiphakathi yendawo ngokuletha ukunakekelwa kwekhwalithi ephezulu kubo bonke abakudingayo.
Ngokuhlanganiswa kwezibhedlela zayo, amalebhu, kanye nezikole, iNtaba iSinayi inikeza izixazululo eziphelele zokunakekelwa kwezempilo kusukela ekuzalweni ngokusebenzisa i-geriatrics, izindlela ezintsha ezitholakalayo ezifana nobuhlakani bokwenziwa kanye ne-informatics ngenkathi igcina izidingo zezokwelapha nezomzwelo zeziguli ziphakathi kwakho konke ukwelashwa.Uhlelo Lwezempilo luhlanganisa cishe odokotela bokunakekelwa okuyisisekelo nabakhethekile abayizi-7,300;Izikhungo eziyi-13 zokuhlinza iziguli zangaphandle ezihlanganyelwe kuzo zonke izifunda ezinhlanu zaseNew York City, eWestchester, eLong Island, naseFlorida;kanye nezikhungo zezempilo zomphakathi ezingaphansi kuka-30.Sikleliswa ngokungaguquguquki Izibhedlela Ezingcono Kakhulu ze-US News & World Report, ezithola izinga eliphezulu le-“Honor Roll”, futhi sikleliswe endaweni ephezulu: No. 1 ku-Geriatrics kanye ne-top 20 ku-Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology /I-Neurosurgery, I-Orthopedics, I-Pulmonology/Ukuhlinzwa Kwephaphu, Ukuvuselela, kanye Ne-Urology.I-New York Eye and Ear Infirmary yaseMount Sinai ikleliswe endaweni ye-12 ku-Ophthalmology.“Izibhedlela Ezingcono Kakhulu Zezingane” ze-US News & World Report ziklelisa i-Mount Sinai Kravis Children's Hospital phakathi kwezihamba phambili zezwe kwezokwelashwa kwezingane.
Isikhathi sokuthumela: Nov-10-2023