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Predictive value of left ventricular ejection fraction in stem cell transplantation.

机译:左心室射血分数在干细胞移植中的预测价值。

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We evaluated predictive value of left ventricular ejection fraction at rest (REF) and its increment with exercise (deltaEF) on autologous and allogeneic stem cell transplantation mortality. In a 7 year period, a total of 163 patients evaluated for stem cell transplantation were studied. All were followed for at least 3 months after the transplant. REF was discriminatory for peritransplant mortality only in younger (<43 years) patients (n = 66), particularly those who underwent autologous transplantation (n = 30). Resting ejection fraction was not a discriminator for early death in any other subgroup. Cardiac reserve (deltaEF) was significantly lower in patients (n = 35), who died early. The finding was most prominent in younger patients who underwent autologous transplantation (n = 26). Combination of decreased REF and low deltaEF (n = 18) was associated with high peritransplant mortality (56%), after both autologous and allogeneic transplantation. A low REF with an appropriate deltaEF (n = 43) was associated with a 19% peritransplant mortality and no deaths in the autologous group. These observations indicate that resting ejection fraction is of only limited value for pretransplant evaluation. However, measurement of cardiac reserve during exercise can provide important prognostic information before stem cell transplantation.
机译:我们评估了静息时左心室射血分数(REF)及其随运动增加的增量(deltaEF)对自体和异体干细胞移植死亡率的预测价值。在7年的时间里,总共对163名接受干细胞移植评估的患者进行了研究。移植后至少随访3个月。 REF仅对年轻(<43岁)患者(n = 66),尤其是进行自体移植(n = 30)的患者具有围手术期死亡率的歧视性。在任何其他亚组中,静息射血分数均不能区分早期死亡。早期死亡的患者(n = 35)的心脏储备量(deltaEF)显着降低。该发现在接受自体移植的年轻患者中最为突出(n = 26)。自体移植和同种异体移植后,REF降低和deltaEF低(n = 18)的组合与移植围手术期高死亡率(56%)相关。具有适当deltaEF(n = 43)的低REF与19%的移植后死亡率相关,而自体组无死亡。这些观察结果表明静息射血分数对于移植前评估仅具有有限的价值。然而,在运动期间测量心脏储备可以在干细胞移植之前提供重要的预后信息。

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