Ese umutima wawe waracitse intege? Reka twige ibijyanye na Ventricular Dyssynchrony mu buryo bworoshye!

Ese rimwe na rimwe wumva ufite ikibazo cyo guhumeka nabi, unaniwe igihe cyose, cyangwa ufite amaguru yabyimbye? Ibi rimwe na rimwe bishobora kuba ibimenyetso by'ikibazo cy'umutima wawe. Uyu munsi tugiye kuvuga ku ndwara igira ingaruka ku mikorere y'umutima, ariko birashoboka ko tutarabyumva byinshi kuri yo. Iyo ni ventricular dyssynchrony , cyangwa nk'uko abaganga bayita, ``(Ventricular Dyssynchrony)``. Nubwo izina rishobora kumvikana nk'irigoye gato, reka tubisobanure mu buryo bworoshye.

Dyssynchrony ya Ventricular ni iki?

Mu magambo make, arrhythmia y'umutima ni igihe kimwe cyangwa byinshi mu byumba byo hasi by'umutima wawe, byitwa ventricles , bikubita mu buryo butangana kandi nta guhuza. Tekereza ko hari gutinda gato kwa milisegonda 40 hagati y'ibice bitandukanye by'uturemangingo tw'umutima wawe bitangiye kwirema, cyangwa hagati y'uturemangingo kamwe gatangiye kwirema ugereranije n'utundi. Ibyo bishobora gufatwa nk'arrhythmia.

Umutima wacu ukora neza gusa iyo imitsi yo mu byumba byawo ikora icyarimwe kandi mu buryo bumwe. Ubusanzwe, ibimenyetso by'amashanyarazi binyura mu mutima mu buryo bunoze cyane. Iyo ibyumba bibiri by'ingenzi by'umutima byakiriye ikimenyetso cyo guhomba, imitsi yo muri ibyo byumba igomba guhomba ku rugero rumwe kandi icyarimwe. By'umwihariko, ventricle yawe y'ibumoso, icyumba cy'ingenzi cyo gupompa cy'umutima, igomba guhomba mu buryo bunoze cyane. Ni nko gusunika uhereye ku mpande zombi ugana hagati.

Ariko, iyo iki kimenyetso kitageze ku turemangingo twombi tw'umutima icyarimwe, imitsi ntishobora gufunga icyarimwe. Ibyo ni byo twita dyssynchrony .

Indwara yo kudahuza kw'amaseli ishobora kugira ingaruka ku mubiri wawe mu buryo bukurikira:

• Bigabanya ubushobozi bw'umutima wawe.
• Utumashini dusanzwe dufasha amaraso gutembera mu cyerekezo kimwe gusa dushobora gutuma amaraso atembera inyuma (mu cyerekezo kitari cyo).
• Ingano y'amaraso umutima wawe ushobora gukompa (Cardiac Output) iragabanuka.

Ni ubuhe bwoko bw'indwara zo mu mutima zifata umutima?

Hari ubwoko bwinshi bw'ingenzi bwa asynchrony y'ingirabuzimafatizo:

• Ubudahangarwa bw'umutima mu mutima: Iki ni igihe ibyumba byo hejuru (atria) n'ibyumba byo hasi (ventricles) by'umutima wawe byikora nta guhuza kw'imitsi.
• Ubudahangarwa bw'imitsi hagati y'umutima: Muri ibi, imitsi yawe y'ibumoso n'iburyo (ibyumba byo hasi) irahuzagurika mu bihe bitandukanye.
• Intraventricular Dyssynchrony: Muri ibi, imitsi yo mu bice bitandukanye by'uturemangingo tumwe irakurura mu bihe bitandukanye. Tekereza nk'inkuta z'icyumba zirunda mu bihe bitandukanye, aho kwisunika imbere icyarimwe.

Ni nde ubangamirwa cyane n'ihindagurika ry'uturemangingo?

Iyi ndwara ikunze kugaragara ku bantu bafite indwara zikurikira:

• Abantu bafite ikibazo cy'umutima.
• Ishami ry'ibumoso ry'agace k'ishami (LBBB).
• Ishami ry'Iburyo (RBBB).
• Indwara z'imitsi y'umutima `(Cardiomyopathy)`.
• Umuvuduko w'amaraso ukabije.
• Izindi ndwara z'umutima.

Tekereza kuri Marume Somapala wo mu mudugudu wacu. Yari amaze igihe arwaye indwara ya `(Umutima unanirwa)`. Mu minsi ishize, yari afite ikibazo cyo guhumeka no kunanirwa cyane. Ubwo muganga yamusuzumaga, yavuze ko afite iyi ndwara yitwa `(Ventricular Dyssynchrony)` mu mutima we, ari nayo mpamvu ibimenyetso bye byarushijeho kwiyongera.

Iyi ndwara ikunze kugaragara gute?

Hafi kimwe cya gatatu cy'abantu bafite ikibazo cy'umutima bashobora guhura n'ubu bwoko bw'indwara yo kudahuza uturemangingo. Hafi 2% by'abantu bakuru bo mu bihugu byateye imbere barwara indwara yo kudahuza uturemangingo. Nanone, hagati ya 6% na 10% by'abantu barengeje imyaka 65 bafite ikibazo cy'umutima. Rero, iyi ndwara nayo igaragara muri ibyo.

Ibimenyetso ni ibihe?

Kudahuza kw'uturemangingo bishobora kongera ibimenyetso by'umutima, cyangwa bigatera ibimenyetso byihariye. Ibi ni byo by'ingenzi:

• Kugorwa no guhumeka (cyane cyane iyo unaniwe).
• Kumva unaniwe cyane (nubwo byaba ari akanya gato gusa).
• Inkorora (ishobora kuba ihoraho).
• Kubyimba (edema) mu mubiri (cyane cyane ahantu nko ku maguru no ku tuguru).

Ni izihe mpamvu zitera kudahuza kw'uturemangingo?

Ibibazo byinshi bitandukanye by'umutima bishobora kubitera. Bimwe muri byo ni:

• Indwara idakora neza yo mu miyoboro y'amaraso.
• Inkovu y'umubiri iterwa n'indwara y'umutima.
• Gutinda gukwirakwiza amashanyarazi, birimo imiterere nk'ishami ry'ibumoso n'ishami ry'iburyo.
• Imitsi y'umutima irwaye.
• Amaraso adahagije ajya mu mitsi y'umutima (Ischemia).

Ni ibihe bipimo bikorwa kugira ngo hamenyekane iyi ndwara?

Muganga wawe azabanza kukubaza ibimenyetso byawe hanyuma agukorere isuzuma ry’umubiri kugira ngo apime imikorere y’umutima wawe. Hari igihe kumva umutima wawe ukoresheje stethoscope nabyo bishobora kuguha igitekerezo cy’ubu buryo bwo kudahuza.

Ikizamini nyamukuru gikoreshwa mu gusuzuma ibibazo biri mu buryo bw'amashanyarazi bw'umutima ni electrocardiogram (ECG) . Gishobora kumenya indwara nka Right Bundle Branch Block na Left Bundle Branch Block, bituma umutima utera nabi. Niba izi ndwara zibonetse kuri ECG, muganga azakujyana kugira ngo uhabwe izindi suzuma.

Abaganga bakunze gukoresha echocardiogram kugira ngo bamenye indwara z'umutima zitera guhagarara neza. Ibi bituma bareba uko ibyumba by'umutima, imitsi n'imitsi bigabanuka.

Hari n'ibindi bizamini bishobora gukorwa:

• Isuzuma rya Positron Emission Tomography (PET).
• Gusuzuma hakoreshejwe uburyo bwa MUGA (Multigated Acquisition).
• Ishusho y'umutima ikoresha magnetic resonance (MRI).
• Isuzuma rya CT (CT scan) rikozwe muri mudasobwa.
• Isuzuma rya "Single Photon Emission Computed Tomography" (SPECT).

Ese uburyo selile idakora neza buvurwa bute?

Abatanga serivisi z'ubuvuzi bashobora kuvura indwara itera selile yawe kudahuza.

Kenshi na kenshi, ubuvuzi bwo gusubiza umutima mu buryo busanzwe (CRT) (bwitwa kandi CRT cyangwa biventricular pacemaker) bushobora gufasha umutima gutera neza umuvuduko w’umutima binyuze mu kugenzura umuvuduko w’impande zombi z’umutima. Ariko, ubu buryo bwongera ibimenyetso gusa ku bantu 50% kugeza kuri 70% bahabwa ubu buvuzi. Abantu bafite ikibazo gikomeye cyo kudahuza umutima (asynchrony) bashobora kugira icyo bageraho.

Ingorane zo kuvura CRT

Ingorane zikurikira zishobora kubaho mu gihe ushyiramo `CRT` (ikinyabutabire cy’umutima gipima imitsi mu buryo bwa bi-polar) (izi ni gake cyane, ariko ni byiza kuzimenya):

• Pneumothorax.
• Guteranya amaraso hagati y'urukuta rw'igituza n'ibihaha (Hemothorax).
• Gutera umutima.
• Gukangura imitsi itari umutima.
• Imashini ikora mu buryo bw'imitsi igenda iva aho iri.

Nzumva meze neza vuba gute nyuma yo kuvurwa?

Ubuvuzi bwa CRT bugabanya uburyo selile zikora akazi gasanzwe gashoboka ako kanya. Hari abantu batangira kumva bameze neza mu byumweru bike nyuma yo gushyirwamo igikoresho. Hari kandi n'inyungu z'igihe kirekire:

• Kunoza ingano y'amaraso atangwa n'umutima wawe (Cardiac Output).
• Kugabanya amaraso ava mu gice cyo hagati cy'imitsi.
• Kunoza ireme ry'ubuzima bwawe.
• Intera ushobora kugenda mu minota itandatu iriyongera.

Ni uwuhe muti ukoreshwa?

Ku ndwara zitera atrial fibrillation, nko kunanirwa k'umutima, cardiomyopathy, cyangwa umuvuduko ukabije w'amaraso, muganga ashobora kukwandikira imiti nka:

• Inhibitors za Angiotensin-Converting Enzyme (ACE).
• Ibikoresho bifunga ubwandu bwa Angiotensin II (ARBs).
• Beta-Blockers.
• Imiti igabanya ubukana bw'amaraso (diuretics).

Nubwo iyi miti ishobora kunoza imikorere y'umutima wawe ku rugero runaka, ntabwo ishobora gusubiza inyuma burundu ikibazo cyo kudahuza kw'imitsi giterwa n'imikorere mibi y'amashanyarazi. Niyo mpamvu hakenewe ubuvuzi nka CRT.

Ni gute wagabanya ibyago byo kudahuza kwa selile?

Ikintu cyiza wakora ni ukwita ku mutima wawe neza. Nubikora, uzabasha kwirinda zimwe mu ndwara zitera kudahuza kw'uturemangingo.

Bumwe mu buryo bwo kurinda umutima wawe:

• Kurya indyo irimo ibinure bike (gabanya amavuta n'ibiryo bikaranze).
• Kora imyitozo ngororamubiri nibura iminota 30 iminsi myinshi (ndetse no kugenda n'amaguru ni byiza).
• Kugukomeza kugira ibiro byiza.
• Gufata umuti neza neza nk'uko muganga yabigutegetse.

Bigenda bite iyo mfite asynchrony ya selile?

Indwara yo mu bwonko bw'ibumoso (LVD) ntabwo ivurwa, kandi ingaruka zayo si nziza cyane. Abantu bafite LVD bafite ibyago byinshi byo kurwara indwara z'umutima kurusha abadafite iyo ndwara. Ushobora kugira indwara yo mu bwonko bw'ibumoso (cyangwa zombi), ariko ventricle yawe y'ibumoso ni yo itera amaraso akungahaye kuri ogisijeni mu mubiri wawe wose. Iyi ni ingenzi cyane.

Uburyo bwo kuvura bwitwa `CRT` (dual-cell pacemaker) bushobora gufasha abantu bafite ikibazo cy'umutima kugabanya iminsi yo mu bitaro no kubaho igihe kirekire.

Wibuke ko impamvu nyamukuru ituma habaho ihindagurika ry’imiterere y’umubiri (asynchrony) igira ingaruka ku musaruro. Imimerere y’abantu bamwe ishobora kuba mibi kurusha abandi.

Nitwara nte?

• Niba muganga wawe yakwandikiye imiti, menya neza ko uyifata neza nk'uko byategetswe . Fata imiti nk'uko byategetswe kugeza igihe muganga wawe azakubwiriye kuyihagarika.
• Niba ufite ikinyabutabire cy'umutima gipima imitsi y'umutima (biventricular pacemaker), ibuka kujya kwa muganga ku matariki yagenwe . Aha niho muganga wawe ashobora kugenzura niba ikinyabutabire cy'umutima gikora neza. Hari ibitaro bifite amavuriro yihariye yitwa CRT clinics. Aho, abaganga b'indwara z'umutima n'inzobere mu by'umutima bakorana kugira ngo barebe ko wungukira cyane kuri iki ginyabutabire cy'umutima.

Ni ryari ngomba kubonana na muganga wanjye?

• Niba utari kumva umeze neza ukoresheje imiti yandikiwe.
• Niba hari ikibazo kuri pacemaker yawe ya biventricular.

Mu bihe nk'ibyo, hita ubonana na muganga.

Ni ryari nkwiye kujya mu ishami rishinzwe ubutabazi bwihutirwa (ETU) ?

Niba ubonye kimwe muri ibi bimenyetso , shaka ubufasha bwa muganga ako kanya:

• Kubabara mu gituza cyangwa kubabara mu mutima.
• Vertigo (kumva usa n'urimo kuzunguruka).
• Guhumeka bigoranye cyane.
• Kubabara mu gifu, isesemi.
• Kubabara umugongo, ijosi, cyangwa urwasaya.

Ni ibihe bibazo ngomba kubaza muganga wanjye?

Ntukibagirwe kubaza ibi bibazo igihe ugiye kwa muganga wawe:

• Kuki nagize uburyo bwo guhuza imikorere y'uturemangingo (cell asynchrony)?
• Ese nkwiriye kuvurwa na `CRT`?
• Ese hari amatsinda y'ubufasha afasha abantu bafite indwara z'umutima?

Ni ibisanzwe kumva uhangayitse gato iyo umenye ko umutima wawe udakora neza. Ariko ntugahangayike. Muganga wawe ashobora kubona icyateye arrhythmia yawe maze agahitamo uburyo bwiza bwo kuvura. Kurikiza amabwiriza ari ku icupa ry'umuti neza. Gufata umuti wawe icyarimwe buri munsi bizagufasha kwibuka kuwufata. Shyira akamenyetso ku matariki yo kubonana na muganga cyangwa ushyireho ikimenyetso kuri telefoni yawe. Ibi bizagufasha kwirinda kuwubura.

Incamake n'ubutumwa bwo kujyana mu rugo

Sawa, rero ndizera ko ubu usobanukiwe neza ``Ventricular Dyssynchrony'' twavuzeho uyu munsi.

Mu magambo make, iyi ni indwara aho ibice byo hasi (uturemangingo) tw'umutima dutera mu buryo butangana, bitajyanye. Ibi bishobora kugabanya imikorere y'umutima, ndetse bigatera ibimenyetso nko kubura umwuka no kunanirwa.

• Ibizamini nka `(ECG)` na `(Echocardiogram)` bifasha gusuzuma iyi ndwara.
• Nk'ubuvuzi, uretse kuvura indwara isanzwe, uburyo bwo kuvura indwara ziterwa n'imitsi bwitwa "Cardiac Resynchronization Therapy (CRT)" nabwo ni ingenzi cyane.
• Kwita ku mutima wawe no gukurikiza ubuzima bwiza bigira uruhare runini mu kwirinda indwara nk'izo.
• Niba ufite ibi bimenyetso, ntutindiganye gushaka inama kwa muganga. Uko indwara igaragaye vuba kandi igakira, niko umusaruro uba mwiza.

Wibuke ko umutima wawe ari wo mutungo wawe w'agaciro kenshi. Ni inshingano zawe kuwurinda.

Indwara z'umutima, kudahuza kw'imitsi y'amaraso, tachycardia y'imitsi y'umutima, indwara y'umutima, CRT, pacemaker