Tumi a koma no tumi de pɔmpɛ: Momma yensua Ejection Fraction ho ade pɛpɛɛpɛ!

So woate asɛmfua ‘Ejection Fraction’ pɛn? Ebia woate afi wo duruyɛfo anaa w’abusua muni bi hɔ bere a na wɔreka komayare ho asɛm no. Nokwarem no, ɛyɛ ade a ɛho hia yiye, na ɛyɛ nea ɛkyerɛ sɛnea yɛn koma wɔ apɔwmuden. Enti, ɛnnɛ yɛbɛka nea saa ‘Ejection Fraction’ yi yɛ ne nea ɛka fa yɛn koma akwahosan ho no ho asɛm kɔ akyiri .

Dɛn ne Ejection Fraction? Sɛ yɛbɛka no tiawa a...

Sɛ yɛbɛka no tiawa a, Ejection Fraction yɛ nea ɛkyerɛ sɛnea wo koma no de mogya kɔ yiye. Sɛ yɛbɛka no pɛpɛɛpɛ a, ɛyɛ mogya dodow a woyi fi adan atitiriw (a wɔsan frɛ no ventricles) a ɛwɔ koma no ase no mu bere biara a ɛrebɔ no.

Sɛ yɛbɛte eyi ase a, momma yɛnkae sɛnea mogya sen fa koma no mu no tiawa:

1. Mogya di kan hyɛn koma no atifi nifa so (wɔfrɛ eyi `right atrium`).

2. Afei, wɔ home tiawa a ɛda koma bɔ ntam no, mogya yi fa valve bi mu na ɛboaboa ano wɔ dan a ɛwɔ fam (`benkum ventricle`) a ɛwɔ koma no benkum so no mu.

3. Afei, sɛ mogya ahyɛ benkum so ahurututu yi ma, bere a koma bɔ a edi hɔ no, wɔde saa mogya no fã bi kɔ nipadua no fã a aka no mu. Mogya dodow a wɔpam fi mu no ne nea yɛde ejection fraction susuw.

Dɛn ne koma a ɛwɔ apɔwmuden no fã a ɛfata a ɛma wotumi fi nipadua no mu?

Mpɛn pii no, ɛsɛ sɛ koma a ɛwɔ apɔwmuden na ɛyɛ adwuma yiye no fã a wɔtow gu no yɛ 50% kosi 70% . Wei kyerɛ sɛ, sɛ koma no bɔ pɛnkoro a, mogya a ɛwɔ benkum so ahurututu no mu 50% kosi 70% na ɛkɔ nipadua no mu.

Nanso eyi nso wɔ hɔ. Ebia nnipa binom wɔ ejection fraction a ɛfata, nanso ebia wɔda so ara wɔ komayare. Yɛfrɛ eyi `Koma a Ɛnyɛ Den a wɔakora so Ejection Fraction (HFpEF)`. Eyi kyerɛ sɛ ɛwom sɛ ejection fraction no ye de, nanso ɔhaw afoforo a ɛwɔ koma no mu na ɛde koma no di huammɔ.

Dɛn nti na ɛho hia sɛ wuhu me Ejection Fraction?

Wo Ejection Fraction yɛ ade titiriw a ɛkyerɛ sɛnea wo koma reyɛ adwuma yiye. Ejection Fraction a ɛba fam taa kyerɛ sɛ wowɔ komayare anaasɛ wowɔ asiane mu. Enti, saa botae yi a wubehu no ho hia yiye ma ayaresa ho nhyehyɛe ne wo koma tebea a wobɛhwɛ so.

So Ejection Fraction ahorow ahorow wɔ hɔ?

Yiw, wobetumi ayɛ saa susudua yi titiriw wɔ koma no benkum ne nifa adan (`ventricles`) nyinaa mu.

Benkum so Ahunmu a Ɛma Nnipa Nsu Mu (LVEF) .

Yɛtaa ka koma no benkum ho asɛm sɛ Ejection Fraction. Ɛfiri,Benkum so ahurututu no de mogya a oxygen pii wom kɔ akwaa ahorow a ɛwɔ nipadua no nyinaa mu no mu. Enti, saa `LVEF` botae yi boa ma wohu sɛ ebia mmerɛwyɛ bi wɔ koma no benkum so, na sɛ ɛte saa a, sɛnea emu yɛ den.

Nifa Ventricular Ejection Fraction (RVEF) a Ɛma Nnipa Yɛ Fɛ (RVEF) .

Eyi kyerɛ mogya dodow a oxygen nnim na ɛho ntew fi koma no nifa so kɔ ahurututu no mu (baabi a wɔsan de oxygen ma no). Saa RVEF botae yi ho hia sɛ wowɔ koma nifa a entumi nyɛ adwuma yiye a. Nanso, saa tebea yi ntaa mma te sɛ benkum fam koma a entumi nyɛ adwuma yiye.

Dɛn na Ejection Fraction gyinapɛn ahorow kyerɛ?

Sɛ yɛbɛka no tiawa a, dodow a wo Ejection Fraction no ba fam no, dodow no ara na wo koma no tumi a ɛbɔ mogya no yɛ mmerɛw. Wohu eyi wɔ nnipa a wɔwɔ komayare a emu yɛ den mu. Ebetumi nso ayɛ nea ɛba fam wɔ komayare mfiase. Ayaresa a wubetumi apaw no gyina sɛnea wo Ejection Fraction no ne nea ɛte daa no ntam kwan ware so.

• Sɛ ɛwɔ 40% ne 49% ntam a: Wɔfrɛ eyi `mid-range ejection fraction`. Eyi kyerɛ sɛ tumi a koma no tumi de pɔmpɔ no sua kakra sen sɛnea ɛte daa. Ebia worennya komayare ho sɛnkyerɛnne biara. Anaasɛ, sɛnkyerɛnne ahorow betumi aba bere a worebɔ mmɔden, te sɛ bere a woreyɛ apɔw-mu-teɛteɛ, na akɔ bere a woagye w’ahome no.
• 39% anaa nea ennu saa: Wɔfrɛ eyi `Koma a ɛyɛ mmerɛw a wɔatew Ejection Fraction (HFrEF)`. Eyi kyerɛ sɛ tumi a wɔde bɔ pɔmpɛ no sua koraa sen sɛnea ɛte daa. Dodow a ejection fraction no sua no, dodow no ara na asiane a ɛwɔ hɔ sɛ wobenya nsɛnnennen a ɛde nkwa to asiane mu te sɛ koma a ɛtwetwe mpofirim (`Cardiac Arrest`) no yɛ kɛse. Nsɛnkyerɛnne no betumi ayɛ den, na ebia wobɛte nka sɛ wo ho nyɛ wo dɛ sɛ wobɛtra ase kɛkɛ mpo.

So komayare (HFpEF) betumi aba sɛ ejection fraction no yɛ nea ɛfata mpo a?

Yiw, sɛnea yɛadi kan aka no, wɔ tebea a wɔfrɛ no `Heart Failure with preserved Ejection Fraction (HFpEF)` mu no, koma no de mogya pii kɔ nipadua no mu bere a ɛbɔ no. Nanso, ɔhaw no ne sɛ mogya dodow a wɔkora so wɔ benkum ahurututu no mu nyinaa so tew. Nea enti a ɛte saa ne sɛ koma ntini no yɛ den anaasɛ ɛyɛ den, na ɛma ɔdan no kɛse so tew. Afei, nipadua no ntumi nkɔ mogya pii sɛnea ehia.

Ebia wobɛkɔ asiane mu sɛ wubenya HFpEF esiane nneɛma a edidi so yi nti:

• Cardiac Tamponade (nsu a ɛboaboa ano wɔ koma no ho) .
• Coronary Ntini mu Yare
• Koma mu Valve Yare
• Mogya Nhyɛso a Ɛkɔ Anim

Dɛn ne nneɛma a ɛma ejection fraction so tew?

Koma ntini mu nhama a ɛte apɔw ho hia na ama koma no mu ntini ahorow no atumi atwetwe mogya na akɔ. Sɛ tebea bi wɔ hɔ a ɛma koma ntini no yɛ mmerɛw anaasɛ ɛsɛe a, saa twetwe yi mma yiye, na pɔmpɛ no so tew.

Afei ɛsɛ sɛ koma no yɛ adwumaden kɛse na ama watumi ayɛ n’adwuma. Saa nhyɛso a ɛboro so yi betumi ama koma no ahonhon anaasɛ ayɛ akuru ntini. Eyi ma ɛyɛ den sɛ mogya bɛhyɛ adan no mu ma na wɔabɔ mogya. Sɛ wo ejection fraction no so tew kakra mpo a, ebia mfiase no worenhu nsonsonoe kɛse. Nanso sɛ wo koma dwumadi so tew nkakrankakra na wo ejection fraction no mu yɛ den a, wubetumi ayare denneennen.

Dɛn ne sɛnkyerɛnne ahorow a ɛwɔ ejection fraction a ɛba fam ho?

Mpɛn pii no , dodow a ejection fraction no sua no, dodow no ara na komayare ho sɛnkyerɛnne ahorow no mu yɛ den. Ebia wubehyia nneɛma te sɛ:

• Adwene a ɛyɛ basaa: Ɛyɛ den sɛ wubesusuw nneɛma ho yiye.
• Ɔbrɛ: Ɔbrɛ a wobɛte nka bere a wowɔ adwuma kɛkɛ mpo no.
• Koma a ɛbɔ: Ɛyɛ obi a ɔte nka sɛ ɔrebɔ anaasɛ ɔrebɔ wɔ koko mu.
• Abofono.
• Ɔhome a ɛyɛ den: Ɛyɛ den sɛ ɔbɛhome, titiriw bere a ɔda fam no.
• Nsu a ɛtwetwe: Tebea a ɛma yafunu anaa nan ho ahonhon wɔ nsu mu.
• Mrɛyɛ.

Kae sɛ, sɛ wowɔ saa sɛnkyerɛnne ahorow yi a, ɛho hia yiye sɛ wohwehwɛ aduruyɛfo afotu ntɛm ara.

Na sɛ Ejection Fraction no korɔn sen sɛnea ɛte daa nso ɛ?

Ɛntaa nsi koraa sɛ ejection fraction bɛyɛ 75% anaa nea ɛboro saa. Nanso sɛ ɛba a, ebetumi ayɛ nea asiane wom. Eyi betumi ato nnipa a wɔwɔ tebea horow te sɛ `Hypertrophic Cardiomyopathy` (koma ntini a ɛyɛ den a ɛnyɛ ne kwan so).

Hena na ɛsɛ sɛ wɔsusuw ne ejection fraction?

Sɛ wowɔ yare anaa asiane bi a ebetumi ama wo koma ayɛ adwuma yiye a, wo ejection fraction a wubehu no so wɔ mfaso kɛse. Wɔ nsɛm te sɛ eyinom mu no:

• Nyarewa te sɛ `ATTR Amyloidosis` a ɛka koma no.
• Nnuru a wɔde sa kokoram anaa nyarewa afoforo bi betumi asɛe koma no (cardiotoxicity).
• Komayare a Wɔde Awo Wɔn.
• Sɛ wowɔ komayare a.
• Koma mu Valve Yare.
• Myocarditis a ɛyɛ mmerɛw.
• Mogya mmoroso a emu yɛ den.
• Koma a ɛbɔ a ɛnteɛ wɔ koma no mu (`Ventricular Arrhythmia`).

Ɔkwan bɛn so na wɔde Ejection Fraction di dwuma de sa yare?

Saa gyinapɛn yi boa nnuruyɛfo ma wɔpaw komayare ho ayaresa a eye sen biara ma wo. Afei nso, sɛ wohwɛ wo ejection fraction bere ne bere mu wɔ w’ayaresa no nyinaa mu a, ebetumi aboa ma woahu sɛ wo koma no dwumadi retu mpɔn anaa.

Komayare ayaresa atitiriw no bi ne:

• Afiri soronko bi a wɔde yɛ apɔw-mu-teɛteɛ (`Biventricular pacemaker`).
• Nnuru a wɔde sa komayare.
• Koma a wɔde si ananmu.
• Koma valve a wosiesie anaasɛ wɔsesa.
• Afiri ketewa bi a wɔde hyɛ nipadua no mu a ɛde anyinam ahoɔden a egye ntɛmpɛ kɔ koma no mu (Implantable Cardioverter Defibrillator - ICD).

Ɔkwan bɛn so na wɔsusuw Ejection Fraction?

Akwan pii wɔ hɔ a wɔfa so susuw ejection fraction. Sɔhwɛ a wɔtaa de di dwuma ne echocardiogram, a ɛte sɛ koma no mu ultrasound scan.

Bio nso, saa sɔhwɛ ahorow yi nso betumi asusuw ejection fraction:

• Koma mu Catheter a Wɔde Ma.
• `CT` mfonini a wɔde hwɛ koma no (`Cardiac Computed Tomography (CT) scan`).
• Koma mu MRI.
• `MUGA` scan (`Multigated Acquisition Scan`), a wɔsan frɛ no `Nuklea Adwennwen Sɔhwɛ`.

So metumi ama me Ejection Fraction no atu mpɔn?

Yiw, koraa. Koma a entumi nyɛ adwuma yiye ho ayaresa ahorow sa nea ɛde koma no fã a ɛba fam no ba. Sɛ nhwɛso no, sɛ ejection fraction a ɛba fam no fi koma a ɛbɔ a ɛnteɛ (arrhythmia) a, ebia biventricular pacemaker bɛma ahotɔ. Sɛ efi nneɛma afoforo te sɛ mogya mmoroso a, ebia nnuru ho behia.

Afei nso, wubetumi ayɛ nea edidi so yi de atew nhyɛso a ɛwɔ wo koma so no so na woanya w’ayaresa no so mfaso kɛse:

• Apɔw-mu-teɛteɛ a wobɛma akɔ soro: Koma a wobɛsan asiesie ho nhyehyɛe betumi aboa wo ma woafi ase ateɛteɛ w’apɔw mu dwoodwoo.
• Mu duru a ɛfata a wobɛkɔ so akura mu.
• Nkyene (sodium) ne nsu a ɛwɔ aduan mu a wɔbɛtew so.
• Suban a epira te sɛ sigaretnom, nnubɔnenom, ne nsa a wobegyae.

Mɛyɛ dɛn ahu sɛ me ejection fraction no renya nkɔso?

Sɛ wo ejection fraction no sua a, ɛho behia sɛ wokɔ wo duruyɛfo nkyɛn mpɛn pii na wahwɛ so. Ɛho hia sɛ wokɔ aduruyɛ ho nhyehyɛe nyinaa, sɛ wonte nka sɛ woyare mpo a.

Sɛ wo sɛnkyerɛnne ahorow no renya nkɔso a, ebetumi ayɛ sɛnkyerɛnne a ɛkyerɛ sɛ wo ejection fraction no renya nkɔso. Nanso, wo yare no ho sɛnkyerɛnne betumi asɛe anaasɛ sɛnkyerɛnne foforo betumi ada adi. Eyinom betumi akyerɛ sɛ wo ejection fraction no reyɛ kɛse.

Sɛ biribi te sɛ eyi si a, ka kyerɛ wo duruyɛfo ntɛm ara, a wontwɛn sɛ wobɛkɔ wo duruyɛfo a edi hɔ no nkyɛn:

• Ɛyɛ den sɛ wobɛhome, titiriw bere a woada fam no.
• Koma a ɛbɔ ntɛmntɛm a ɛyɛ soronko a wɔte nka.
• Aduan ho akɔnnɔ a ɛyera anaasɛ ɔfe.
• Mu duru a ɛsakra mpofirim (ebia eyi fi nsu a ɛkyere so).
• Wɔtee mmerɛwyɛ anaa adwenemhaw nka a ntease biara nnim.

Mpɛn ahe na ɛsɛ sɛ wɔsusuw Ejection Fraction?

Ebia nnuruyɛfo bɛhaw wo ho wɔ wo ejection fraction ho wɔ tebea horow a edidi so yi mu:

• Sɛ wowɔ komayare ho sɛnkyerɛnne ahorow a.
• Sɛ wowɔ komayare anaa tebea foforo a ɛka koma no dwumadi a.
• Sɛ wowɔ aduruyɛ mu tebea bi a ɛma asiane a ɛwɔ hɔ sɛ wubenya komayare no yɛ kɛse a.

Mpɛn dodow a ɛsɛ sɛ woyɛ nhwehwɛmu yi bere a wɔahu sɛ woanya komayare akyi no gyina nneɛma ahorow bi so, a nea ɛka ho ne sɛnea wo mfitiase ejection fraction no sua. Sɛ wo ejection fraction kɔ so yɛ kɛse a, ebia ɛho behia sɛ wotaa hwɛ mu. Sɛ ɛyɛ nea ɛyɛ den a, ebia ɛho renhia sɛ wɔsɔ wo hwɛ mpɛn pii saa.

So Ejection Fraction nkutoo ne sɔhwɛ a wɔde kyerɛ tebea a Koma a Ɛyare no?

Dabi, ejection fraction yɛ susuw pii a nnuruyɛfo de susuw wo koma tebea ho no mu biako pɛ. Ɛho hia sɛ wɔyɛ nhwehwɛmu foforo na ama wɔahu nea ɛde wo tebea no ba ankasa na wɔama wo ayaresa a ɛfata sen biara.

Ebia sɔhwɛ afoforo yi bi ne:

• Angiography a wɔde yɛ nhwehwɛmu.
• Koko so X-ray a wɔyɛ.
• Echocardiogram a wɔde kyerɛw nsɛm.
• Electrocardiogram (`Ɛlektrɔnik koma ho mfonini - EKG`).
• Apɔw-mu-teɛteɛ mu Adwennwen Sɔhwɛ.

Nea etwa to no, nneɛma a ɛsɛ sɛ wokae (Take-Home Message) .

Ejection Fraction yɛ ade titiriw a ɛkyerɛ sɛnea koma no mu yɛ den. Ɛkyerɛ mogya dodow a oxygen pii wom a koma no de kɔ nipadua no mu bere biara a ɛbɔ no. Mpɛn pii no, ejection fraction a ɛba fam no yɛ koma a entumi nyɛ adwuma yiye ho sɛnkyerɛnne. Nanso mma ɛnhaw wo. Sɛ wosa yare yiye na wosakra w’asetra mu a, mpɛn pii no ɛyɛ yiye sɛ wobɛma wo ejection fraction no asan aba sɛnea na ɛte kan no. Ade a ɛho hia sen biara ne sɛ wubedi wo duruyɛfo akwankyerɛ akyi na woakɔ nhwehwɛmu ne bere a wo ne no kɔ hɔ daa. Eyi bɛboa kɛse ma wo koma atra apɔwmuden.

` Ejection Fraction, Koma Yare, Koma Akwahosan, LVEF, RVEF, Koma Yare Nsɛnkyerɛnne, Koma Ayaresa