Te kaha pupuhi o te ngākau: Me ako tātou mō te wāhanga pana!

Kua rongo kē koe i te kupu 'Ejection Fraction'? Tērā pea kua rongo koe i tēnei kupu mai i tō tākuta, i tētahi mema rānei o te whānau i a rātou e kōrero ana mō te mate manawa. He mea tino nui tēnei, ā, he ine i te hauora o tō tātou ngākau. Nō reira, i tēnei rā ka kōrerohia e tātou he aha te 'Ejection Fraction' me āna kōrero mō te hauora o tō tātou ngākau.

He aha te Ejection Fraction? He māmā noa iho...

He māmā noa iho, ko te Ejection Fraction he ine i te pai o te pupuhi toto a tō ngākau. He tika ake, ko te nui o te toto e tukuna ana mai i ngā rūma matua (e kiia ana ko ngā ventricles) i raro i te ngākau i ia pao.

Hei mārama ki tēnei, me mahara poto tātou ki te rere o te toto i roto i te ngākau:

1. Ka tomo tuatahi te toto ki te taha matau o runga o te ngākau (e kiia ana tēnei ko te 'atrium matau').

2. Kātahi, i te wā poto o te okiokinga i waenganui i ngā pā o te ngakau, ka haere tēnei toto mā roto i tētahi takirere ka kohia ki te rūma o raro ('te ventricle maui') i te taha maui o te ngākau.

3. Ina kī tonu tēnei ventricle maui i te toto, i te pao o te manawa e whai ake nei, ka panahia tētahi wāhanga o taua toto ki te toenga o te tinana. Ko te nui o te toto e panahia ana ko tā tātou e ine ai mā te wāhanga ejektion.

He aha te ōrau ejection normal o te ngākau hauora?

Ko te wāhanga whakaputa o te ngākau hauora, e mahi pai ana, me noho i waenga i te 50% me te 70% . Ko te tikanga, ina pā te ngākau kotahi, ka pupuhihia te 50% me te 70% o te toto i roto i te ventricle maui ki te tinana.

Engari kei reira anō hoki tēnei. Tērā pea he rite tonu te haurua ejection o ētahi tāngata, engari kei te pāngia tonutia rātou e te ngoikore o te ngākau. Ka kiia tēnei e mātou ko te 'He ngoikore o te ngākau me te wāhanga ejection i tiakina (HFpEF)'. Ko te tikanga o tēnei ahakoa he pai te haurua ejection, ko te ngoikore o te ngākau i puta mai i ētahi atu raruraru o te ngākau.

He aha te mea nui kia mōhio ahau ki taku Ejection Fraction?

Ko tō Ejection Fraction tētahi tohu matua mō te pai o te mahi a tō ngākau. Ko te iti o te Ejection Fraction he tohu kei te pāngia koe e te ngoikore o te ngākau, kei te tūpono rānei koe ki te pāngia e te ngoikore o te ngākau. Nō reira, he mea tino nui te mōhio ki tēnei uara mō te whakamahere maimoatanga me te aroturuki i te āhua o tō ngākau.

He rerekē ngā momo wāhanga pana?

Ae, ka taea te ine i tēnei inenga i ngā rūma maui me ngā rūma matau ('ventricles') o te ngākau.

Te Wāhanga Putanga o te Ventricular Mauī (LVEF)

He maha ngā wā ka kōrerohia te taha maui o te ngākau hei wāhanga ejection. Nā te mea,Ka pupuhi te ventricle maui i te toto whai hāora ki ngā whekau puta noa i te tinana. Nō reira, ka āwhina tēnei uara `LVEF` ki te whakatau mēnā he ngoikore kei te taha maui o te ngākau, ā, mēnā he ngoikore, he aha te kaha o te ngoikore.

Te Wāhanga Putanga o te Puku o te Ventricular Matau (RVEF)

Ka ine tēnei i te nui o te toto poke, rawakore hāora, e pupuhihia ana mai i te ventricle matau o te ngākau ki ngā pukahukahu (te wāhi e whakahokia ai te hāora ki te hāora). He mea nui tēnei uara RVEF mēnā he ngoikore ngākau taha matau tōu. Heoi, kāore tēnei āhuatanga i te rite te noa ki te ngoikore ngākau taha maui.

He aha te tikanga o ngā uara o te Ejection Fraction?

Ki te kī ngāwari, ko te iti o tō Ejection Fraction, ko te ngoikore o te kaha o tō ngākau ki te pupuhi toto. Ka kitea tēnei i roto i te hunga e pāngia ana e te ngoikore o te ngākau. Ka iti pea i ngā wāhanga tōmua o te ngoikore o te ngākau. Ko ngā kōwhiringa maimoatanga ka whakawhirinaki ki te tawhiti o tō Ejection Fraction mai i te mea noa.

• Mena kei waenganui i te 40% me te 49%: Ka kiia tēnei ko te 'waenga-waenga ejection fraction'. Ko te tikanga he iti iho te kaha o te manawa e pupuhi ana i te mea noa. Kāore pea he tohu o te ngoikore o te manawa. Tērā pea ka puta ngā tohu i ngā wā e whakapau kaha ana koe, pērā i te wā e whakakorikori ana koe, ā, ka ngaro atu i te wā e okioki ana koe.
• 39%, iti iho rānei: Ka kiia tēnei ko te 'Heart failure with reduced Ejection Fraction (HFrEF)'. Ko te tikanga he iti iho te kaha o te pupuhi i te mea noa. Ko te iti o te ejection fraction, ko te teitei ake o te mōrearea o ngā raruraru morearea pēnei i te hopukanga ohorere o te ngakau ('Cardiac Arrest'). Ka kino pea ngā tohu, ā, ka pāngia pea koe e te kore whakamarie ahakoa te noho noa iho.

Ka taea te pā mai te ngoikore o te ngākau (HFpEF) ahakoa he noa te wāhanga ejection?

Ae, e ai ki tā mātou i kōrero ai i mua ake nei, i roto i te āhuatanga e kīia nei ko te 'Heart Failure with Preserved Ejection Fraction (HFpEF),' ka pupuhi te ngākau i te nui o te toto ki te tinana ina pā. Heoi, ko te raruraru ko te hekenga o te nui katoa o te toto e rongoa ana i roto i te ventricle maui. Nā te mea ka matotoru, ka pakari rānei te uaua o te ngākau, ka whakaiti i te rahi o te ruma. Kātahi, kāore e taea e te tinana te pupuhi i te nui o te toto e hiahiatia ana.

Tērā pea ka tūpono koe ki te whakawhanake i te HFpEF mō ēnei take e whai ake nei:

• Te Tamponade o te Ngākau (te kohikohinga wai huri noa i te ngākau)
• Te mate o te uaua koronari
• Mate Takirere Manawa
• Te toto toto tiketike

He aha ngā take o te hekenga o te haurua ejection?

E hiahiatia ana ngā muka uaua manawa hauora kia taea ai e ngā ventricle o te manawa te whakawhāiti me te pupuhi toto ki waho. Mēnā he āhuatanga e ngoikore ai, e kino ai rānei te uaua manawa, kāore tēnei whakawhāiti e puta tika ana, ā, ka heke te pai o te pupuhi.

Me kaha ake te mahi a te ngākau ki te mahi i tana mahi. Mā tēnei taumahatanga tāpiri ka pupuhi te ngākau, ka puta rānei he kiko whara. Mā tēnei ka uaua ake te whakakī i ngā rūma ki te toto me te pupuhi toto. Ahakoa he iti noa te hekenga o tō wāhanga ejection, kāore pea koe e kite i te rerekētanga nui i te tīmatanga. Engari ki te heke haere te mahi a tō ngākau, ā, ka kino haere tō wāhanga ejection, ka taea e koe te pāngia e te mate kino.

He aha ngā tohu o te iti o te wāhanga ejection?

I te nuinga o te wā , ko te iti o te wāhanga ejection, ko te kaha ake o ngā tohu o te ngoikore o te ngākau. Tērā pea ka pāngia koe e ēnei āhuatanga:

• Pōhēhē: He uaua ki te whakaaro mārama.
• Ngenge: Te ngenge tonu ahakoa kei te mahi noa.
• Te tere o te manawa: He kare ā-roto e pāorooro ana, e pāorooro ana rānei i roto i te uma.
• Whakapairuaki.
• Te mate manawa: Te uaua ki te manawa, ina koa i te wā e takoto ana.
• Te pupuri wai: He āhuatanga e pupuhi ai te puku, ngā waewae rānei i te wai.
• Ngāwari.

Kia maumahara, ki te pā mai ēnei tohu, he mea nui kia rapu tohutohu hauora tonu atu.

He aha mēnā he teitei ake te Ejection Fraction i te mea noa?

He tino onge te ekenga o te wāhanga ejection ki te 75%, neke atu rānei. Engari ki te puta, he mea morearea pea. Ka pā tēnei ki te hunga whai mate pēnei i te 'Hypertrophic Cardiomyopathy' (he matotoru rerekē o te uaua o te ngākau).

Ko wai te haurua pana e tika ana kia inehia?

Mena he mate, he tūponotanga rānei tōu e arahi atu ai ki te ngoikore o te ngākau, he mea tino whai hua te mōhio ki tō ejection fraction. Mō ēnei āhuatanga:

• Ngā mate pēnei i te `ATTR Amyloidosis` e pā ana ki te ngākau.
• Ka taea e ētahi maimoatanga chemotherapy mō te mate pukupuku, te mate rānei te whakararu i te ngākau (cardiotoxicity).
• Mate Manawa Whānau.
• Ki te pāngia koe e te mate manawa.
• Te Mate Takirere Manawa.
• Te mate ngakau.
• Te toto toto tiketike rawa.
• Te pāorooro o te ngākau i ngā rūma o te ngākau ('Arrhythmia Ventricular').

Me pēhea te whakamahi i te Ejection Fraction mō te maimoatanga?

Mā tēnei uara ka āwhina ngā tākuta ki te whiriwhiri i te maimoatanga pai rawa atu mō te ngoikore o te ngākau. Waihoki, mā te tirotiro i tō wāhanga ejection i ia wā puta noa i tō maimoatanga ka āwhina i te whakatau mēnā kei te pai haere te mahi a tō ngākau.

Ko ētahi o ngā maimoatanga matua mō te whakaeke ngakau ko:

• He momo taputapu whakatere motuhake ('Pacemaker Biventricular').
• Ngā rongoā mō te ngoikore o te ngākau.
• Te whakawhitinga ngākau.
• Te whakatikatika, te whakakapi rānei i te takirere ngākau.
• Te whakaurunga o tētahi taputapu iti ki roto i te tinana hei tuku i te ru hiko ohorere ki te ngākau (Implantable Cardioverter Defibrillator - ICD).

Me pēhea te ine i te Hautanga Whakaputa?

He maha ngā huarahi hei ine i te wāhanga ejection. Ko te whakamātautau e whakamahia whānuitia ana ko te echocardiogram, he rite ki te matawai ultrasound o te ngākau.

Hei tāpiritanga, ka taea hoki e ēnei whakamātautau te ine i te wāhanga whakaputa:

• Te whakaurunga o te kāteretere o te ngākau.
• He matawai `CT` o te ngākau (`Cardiac Computed Tomography (CT) scan`).
• MRI o te ngākau.
• Ko te matawai `MUGA` (`Matawai Whiwhinga Maha`), e kiia ana hoki ko te `Whakamātautau Taumahatanga Karihi`.

Ka taea e au te whakapai ake i taku Ejection Fraction?

Āe, tino tika. Mā ngā rongoā mō te ngoikore o te ngākau ka rongoatia te pūtake o te iti o te wāhanga ejection. Hei tauira, mēnā ko te iti o te wāhanga ejection nā te koretake o te ngakau (arrhythmia), ka taea e te taputapu pacemaker biventricular te whakaora. Mēnā nā ētahi atu take, pērā i te toto toto tiketike, me whakamahi pea i ngā rongoā.

Hei tāpiri atu ki tēnā, ka taea e koe te mahi i ēnei hei whakaiti i te taumahatanga ki tō ngākau, hei whiwhi hoki i te hua pai rawa atu o tō maimoatanga:

• Te whakanui ake i te korikori tinana: Ka taea e te kaupapa whakaora ngakau te āwhina i a koe ki te tīmata haumaru i te korikori tinana.
• Te pupuri i te taumaha hauora.
• Te whakawhāiti i te tote (konutai) me ngā wai i roto i te kai.
• Te whakarērea o ngā tikanga kino pērā i te kai hikareti, te tarukino, me te waipiro.

Me pēhea taku mōhio kei te pai haere taku wāhanga ejection?

Mena he iti tō ejection fraction, me toro atu koe ki tō tākuta kia aroturukihia ai. He mea nui kia haere koe ki ngā wā tirotiro hauora katoa, ahakoa kāore koe e māuiui ana.

Mena kei te pai haere ō tohumate, he tohu pea tēnei kei te pai haere tō wāhanga ejection. Heoi anō, tera pea ka kino haere ō tohumate, ka puta mai rānei ētahi atu tohumate. Tērā pea ka tohu ēnei kei te kino haere tō wāhanga ejection.

Ki te puta mai tētahi mea pēnei, whakamōhio atu ki tō tākuta tonu, me te kore e tatari mō tō wā tirotiro tākuta e whai ake nei:

• Te uaua ki te manawa, ina koa i te takoto.
• Te rongo i te tere ohorere o te ngakau.
• Te ngaronga o te hiahia kai, te ruaki rānei.
• Te panoni ohorere o te taumaha (tērā pea nā te pupuri wai i te take).
• Te ngoikore, te whanoke rānei, kāore he take.

Kia pēhea te auau o te ine i te wāhanga pana?

Tērā pea ka āwangawanga ngā tākuta mō tō wāhanga ejection i roto i ēnei āhuatanga e whai ake nei:

• Mena kei a koe ngā tohu o te ngoikore o te ngakau.
• Mena kei te pāngia koe e te mate manawa, e tētahi atu āhuatanga rānei e pā ana ki te mahi a te manawa.
• Mena kei te pāngia koe e tētahi mate hauora e whakanui ake ai i tō mōrearea ki te mate ngakau.

Ko te auau o te whakamātautau i muri i te tātaritanga o tō mate ngākau he mea whakawhirinaki ki ētahi āhuatanga, tae atu ki te iti o tō haurua ejection tuatahi. Mena ka kino haere tonu tō haurua ejection, me tirotiro pinepine atu pea. Mena he pumau, kāore pea koe e hiahiatia kia tirohia pinepine.

Ko te Ejection Fraction anake te whakamātautau hei aromatawai i te āhua o te ngoikore o te ngākau?

Kāo. Ko te wāhanga ejection tētahi o ngā inenga maha e whakamahia ana e ngā tākuta hei aromatawai i te āhua o tō ngākau. Me whai whakamātautau anō hei whakatau i te tino take o tō āhua, hei hoatu hoki i te maimoatanga tino tika ki a koe.

Ko ēnei whakamātautau tāpiri pea ko:

• Angiography.
• X-ray o te uma.
• Te whakamātautau manawa o te ngākau.
• Te hiko o te manawa ('Electrocardiogram - EKG').
• Whakamātautau ahotea whakakori tinana.

Hei whakamutunga, ngā mea hei maumahara (Karere hei tango ki te kāinga)

He tohu nui te Ejection Fraction mō te kaha o te ngākau. Ka ine i te nui o te toto whai hāora e pupuhihia ana e te ngākau ki roto i te tinana i ia pao. Ko te iti o te ejection fraction he tohu noa iho o te ngoikore o te ngākau. Kaua e manukanuka. Mā te maimoatanga tika me ngā huringa momo noho i a koe, ka taea tonu te whakahoki i tō ejection fraction ki te āhua noa. Ko te mea nui ko te whai i ngā tohutohu a tō tākuta me te haere ki ngā tirotiro me ngā wā whakarite auau. Ka nui te āwhina o tēnei ki te pupuri i te hauora o tō ngākau.

` Te Wāhanga Whakaputa, Te Whakaekenga Manawa, Te Hauora o te Manawa, LVEF, RVEF, Ngā Tohumate o te Mate Manawa, Te Maimoatanga o te Manawa