"Kupa kwemoyo wako" kwakadii? Ngatitaurei nezve 'Coronary Flow Reserve (CFR)'!

Wakambozvibvunza here kana moyo wako uchiwana ropa rakawanda raunoda kana uine stress, sepaya paunorovedza muviri? Mwoyo wedu inhengo inoshamisa. Unoda ropa rakanaka kuti ushande zvakanaka. Ndizvo zvatichataura nezvazvo nhasi, uye zvinotaura zvakawanda nezvehutano hwemwoyo wako: `Coronary Flow Reserve` kana `CFR`. Usazvidya mwoyo, mazwi aya anogona kunzwika akaomarara, asi ngatirambei tichizviita zviri nyore.

Chii chinonzi `Coronary Flow Reserve (CFR)`? Zvichitaurwa zviri nyore...

Funga nezvemoyo wako seinjini yemota. Kana ichishanda zvakanaka, injini inoda mafuta akati wandei. Asi kana uchikwira gomo, kana kuti uchimhanya, injini inoda mafuta akawanda, handiti? Ndizvo zvakaita mwoyo yedu. Patinenge takazorora, mwoyo unoda ropa rakati wandei. Asi patinorovedza muviri, kumhanya, kusvetuka, kusimudza zvinorema, kana kuti tiri pasi pekushushikana, mwoyo unoda okisijeni yakawanda uye zvinovaka muviri . Kuti igutse kudiwa uku kwakawanda, ropa rinoenda kumoyo rinofanira kuwedzera.

Mitsipa mikuru yeropa inotakura ropa kuenda kumoyo inonzi mitsipa yemoyo . Kuchengetedzwa kweropa mumoyo (CFR) inzira yekuyera kuti mitsipa yemoyo inogona kuwedzera sei ropa rayo kana mwoyo uchida ropa rakawanda. Zvakafanana nekutarisa huwandu hweropa rinochengetwa mumoyo.

Izvi zvinonziwo `Myocardial blood flow reserve`. Nekuti ropa rinoyerera kubva mutsinga idzi dzemoyo kuenda kutsandanyama yemoyo wako, ndiko kuti, kutsandanyama yemoyo `(Myocardium)` . Saka kuburikidza neCFR value iyi, vanachiremba vanogona kuongorora kana tsandanyama yemoyo wako iri kuwana ropa rakakwana painorida.

Kukosha kweCFR uku kunoverengwa sei?

Uku kuverenga kuri nyore kwazvo. Asi zvinoda bvunzo dzakakosha kuti zviitwe. Zvichitaurwa zviri nyore, CFR ndiyo nzira yepamusoro yekuyerera kweropa inogona kuyerera kuburikidza netsinga dzemwoyo , yakakamurwa neropa rakajairika rinoyerera nemauri paunenge wakazorora, pasina kushanda nesimba .

Semuenzaniso, kana wakazorora, moyo wako unopomba mamirilita eropa X paminiti. Kana wakanyanya kushanda nesimba (kana kuti chirwere ichocho chinokonzerwa nepfungwa dzekugadzira), moyo wako unopomba mamirilita eropa Y. Ipapo CFR = Y / X.

Uku ndiko kuwanda kweropa iro mwoyo wako unogona kupomba kupfuura zvakajairika.

Ndedzipi nguva apo bvunzo yeCFR inoitiswa?

Pane zvikonzero zvakawanda nei chiremba angakurudzira kuongororwa kweCFR:

• Tsvaga kana uine chirwere chemwoyo (CAD): Dzimwe nguva kurwadziwa kwechipfuva (angina), kunetseka kufemaKana zviratidzo zvakaita seizvi zvikaitika, bvunzo iyi inobatsira kuona kana chikonzero chacho chiri kuvharika kwetsinga dzemwoyo.
• Ongorora kuoma kweCAD: Izvi zvakakosha kuti unzwisise kuti tsinga dzakawanda sei dzinokanganiswa uye kuti ropa rakawanda sei rinovharika mumunhu ane CAD.
• Fanotaura nezvenjodzi yekurwara nemoyo mune ramangwana: Sezvo huwandu hweCFR huchidzikira, njodzi yekurwara nemoyo kana chimwe chirwere chemwoyo mune ramangwana inogona kuwedzera.
• Yera kubudirira kwekurapwa: Bvunzo iyi inogona kushandiswawo kuona kana ropa rakapinda mumoyo rakadzorerwa mushure memamwe marapirwo (semuenzaniso angioplasty, kuvhiyiwa kwe bypass).

Chii chinonzi avhareji yeCFR?

CFR yemunhu ane hutano inowanzova pakati pe2.0 ne2.5 kana kupfuura . Izvi zvinoreva kuti kana uchishanda nesimba, mwoyo wako unowana kuyerera kweropa kaviri kupfuura paunenge wakazorora. Munhu ane hutano anogona kuva nechiyero ichi kusvika pa3. Izvi zvinoreva kuti ane kugona kuwedzera ropa rake katatu.

Imwe ongororo yakawana kuti vanhu vane CFR inodarika miviri vakapora zviri nani kwemwedzi mitanhatu mushure mekurwara nemoyo. CFR iri pasi pe2 inoratidza njodzi yakakura yechirwere chemwoyo.

Asi zvakakosha kunzwisisa kuti kukosha uku "kwakajairika" kunogona kuchinja nekukura. Wechidiki ane hutano hwakanaka anogona kuva neCFR ye5 kana 6. Asi kunyange munhu ane hutano hwakanaka ane makore 80 anogona kuva neCFR iri pasi pe2. Zvakare, mwana akavhiyiwa chirwere chemwoyo chekuzvarwa nacho anogona kunge aine CFR yakaderera. Saka, chiremba wako ndiye achasarudza kana CFR yako iri yakajairika kana kwete, zvichienderana nehutano hwako nezvimwe zvinhu.

Unganyora sei bvunzo yeCFR? Ungagadzirira sei?

Kune nzira mbiri huru dzekuyera CFR. Imwe inzira yekupinda mumuviri , inosanganisira kuisa chimwe chinhu mumuviri. Izvi zvinosanganisira chinhu chinonzi `Cardiac Catheterization`. Imwe nzira isingapindi mumuviri , inosanganisira kushandisa `Nuclear Stress Test` yakakosha, inova `Rubidium-82 Positron Emission Tomography (PET) scan`. Kashoma, `Magnetic Resonance Imaging (MRI) scan` inogona kushandiswawo pachinangwa ichi.

Iye zvino ngationei kuti tingagadzirira sei bvunzo iyi uye zvichaitika pazuva rebvunzo.

Zvinhu zvaunofanira kuziva usati waenda kunoongororwa

• Udza chiremba wako nezvemishonga yauri kutora: kusanganisira mishonga yakanyorerwa nachiremba, mishonga inotengeswa muchipatara, uye mavhitamini.Unofanirawo kuudza chiremba wako nezvemishonga yemushonga yauri kutora, sezvo mimwe mishonga inogona kukanganisa kufamba kweropa.
• Tiudzei nezve allergies dzenyu: Kana muine allergies kune chero mishonga, contrast dye inoshandiswa mukuyedzwa, kana latex, tizivisei pachine nguva.
• Zano rezvekudya nezvinwiwa: Kana uri kuvhenekwa cardiac catheterization kana PET scan, bvunza chiremba wako kuti unofanira kurega kudya kana kunwa maawa mangani usati waongororwa. Kazhinji, haubvumidzwe kudya kana kunwa chero chinhu kwemaawa matanhatu kusvika masere usati waongororwa.

Chii chaunotarisira pazuva rebvunzo?

• Kuongororwa kweMRI: Haufanirwe kunge uine zvinhu zvesimbi (zvakaita sezvishongo kana mapini ebvudzi) mumuviri wako. Zvimwe zvishandiso zvekurapa (zvakaita sepacemakers) zvinogona kusaenderana neMRI. Saka kana uine mudziyo wakadaro, bvunza chiremba wako nguva isati yasvika kuti uve nechokwadi chekuti hauna njodzi yeMRI.
• Kugaya Catheterization yemwoyo: Mukuita uku, chubhu yakatetepa (catheter) inopinzwa neropa mutsinga iri mumutsipa, pahudyu, kana muruoko mutsinga dzemwoyo. Uchapihwa mushonga wekuderedza kushushikana kuti usanyanya kugadzikana.
• Mutsetse weIV: Pasinei nenzira yekuyedza, "Mutsetse weIntravenous (IV)" unobatanidzwa netsinga iri muruoko rwako. Mutsetse uyu ndipo panopiwa mushonga (vasodilator) kuti ropa rifambe zvakanaka kuenda kumoyo uye dzimwe nguva "dhayi reContrast" kuti tsinga dzemoyo dzionekwe zviri nani. Kana uri kuvhenekwa ne "PET scan", mushonga une radioactive "Radiotracer" unopihwawo kuburikidza nemutsetse uyu.

Regai nditsanangure zvishoma nezvekuti CFR inoyerwa sei...

Chiremba wako achashandisa nzira dzakasiyana-siyana dzekuyeresa kuyerera kweropa mutsinga dzemwoyo panguva yekuzorora uye panguva yekurovedza muviri zvakanyanya. Nzira huru ndeidzi:

• `PET scan`: Muizvi, kana `Radiotracer` inopiwa kuburikidza neIV yasvika pamoyo, zviratidzo zvinoburitswa nayo zvinotorwa nekamera yakakosha, uye nerubatsiro rwekombuta, mifananidzo yakajeka yekufamba kweropa mumoyo inowanikwa.
• ` Mwoyo weMRI` : Iyi inzira yekutora mifananidzo zvakare. Zvisinei, haiwanzo shandiswa kuyera CFR.

Zvakakosha kuti urambe wakadzikama panguva yekuskena uku, zvikasadaro mifananidzo yawawana ingasave yakajeka.

Nzira ye `Cardiac Catheterization` yakasiyana zvishoma. Inosanganisira:

1. Kana catheter yaiswa mutsinga yemoyo, waya yakakosha inopfuudzwa nayo. Pamucheto wewaya iyi pane `Ultrasound transducer` (chinhu chidiki chinoburitsa uye chinogashira mafungu eultrasound). Izvi zvinogona kuyera kumhanya kweropa riri kuyerera mukati metsinga yemoyo.

2. Munguva iyi, mushonga unonzi `Heparin` unopihwa kuburikidza neIV kudzivirira kugwinha kweropa.

3. Kune dzimwe mhando dzewaya dzinoyera kuyerera kweropa dzichishandisa masensa maviri ekupisa uye jekiseni resaline.

Chii chaizvo chinoitika panguva yebvunzo?

Munguva yekuongororwa kwako, timu yezvekurapa ichaita zvinotevera:

1. Chekutanga, kuyerera kweropa mutsinga dzemwoyo kunoyerwa paunenge wakazorora .

2. Zvadaro, mushonga wemhando ye`Vasodilator` (wakadai se`Adenosine (Adenocard® kana Adenoscan®)`) unopihwa kuburikidza neIV yako, izvo zvinowedzera kurova kwemoyo uye kuyerera kweropa. Mushonga uyu unowedzera kuyerera kweropa kane kana kusvika kashanu zvichienzaniswa nepaunenge wakazorora. Zvinotora nguva pfupi, ingangoita maminetsi maviri kusvika matatu, kuti mushonga uyu ushande. Izvi zvinonzi `Cardiac Catheterization`, uye dzimwe nguva mushonga uyu unogona kupihwa kuburikidza necatheter panzvimbo peIV.

3. Mushure mekunge mushonga wapihwa, ropa rinoyerera mutsinga dzemwoyo rinoyerwa zvakare. Uku ndiko kuyerera kweropa kwakanyanya.

4. Chekupedzisira, kukosha kwako kwe `Coronary Flow Reserve (CFR)` kunoverengerwa nekuenzanisa kuyerera kweropa kwakanyanya uku uye kuyerera kweropa rako rakazorora .

Chii chinoitika mushure mekuyedzwa?

• Kana wakaisa catheter (kunyanya muhudyu kana muruoko), unofanira kuchengeta nzvimbo yakachekwa yakamira kweawa imwe kana kupfuura kudzivirira kubuda ropa.
• Chiremba wako anogona kukuudza kuti unwe mvura yakawanda kuti ibatsire kubvisa dhayi remhando ye contrast mumuviri wako.
• Kana wakapihwa mushonga wekunyaradza, hauzokwanisi kutyaira motokari pazuva iroro. Saka, uchafanira kuuya nemumwe munhu kuti akutore uende naye kumba .

Ndezvipi njodzi nemigumisiro yebvunzo iyi yeCFR?

Kuongororwa kweCFR kunowanzo kuve nzira yakachengeteka, asi semamwe maitiro ekurapa, kune dzimwe njodzi diki.

• Nekuti macatheter newaya zvinoiswa mutsinga dzemoyo, kashoma kuti ropa rigwambe, tsinga dzitsvedzerere, kana kubuda ropa.
• Pane mukana mudiki wekukuvara kwetsinga dzeropa. Kana izvi zvikaitika, kuvhiyiwa kungangodiwa kuti zvigadzirwe , kashoma.

Kana vamwe vanhu vakapa mushonga we'Adenosine', vanogona kusangana nemigumisiro inotevera, inongotora masekondi mashoma chete:

• Kurira kwemoyo kusina kujairika
• Kuderera kweropa (Hypotension)
• Kushaya mweya
• Kusagadzikana pachipfuva

Zvakakosha: Adenosine haipiwi kuvanhu vane asthma nekuti inogona kukonzera bronchospasms. Muzviitiko zvakadaro, chiremba anogona kushandisa imwe mishonga ye IV yakaita seDobutamine.

Zvakaita sei? Zvinotiudza kuti chii?

Kuongororwa kwako kweCFR kunokupa nhamba. Nhamba iyi inokuudza kuti tsinga dzako dzemwoyo dzinogona kuwedzera sei kuyerera kweropa panguva yekurovedza muviri.

Sezvatakambokurukura, kukosha uku kunogona kudzikira nekukura. Wechidiki ane hutano hwakanaka anogona kuva neCFR ye5 kana 6. Asi munhu mukuru ane hutano hwakanaka anogona kuva neCFR yeisingasviki 2.

Kuderera kweropa (kureva, chinhu chine njodzi) kunogona kuitika chero CFR iri pakati pe1.6 ne3.3. Zvinoitika kune mumwe munhu zvinogona kunge zvisiri izvo kune mumwe. Saka, chiremba wako chete ndiye anogona kududzira zvawakawana nemazvo. Iye achafunga nezvezvinhu zvakawanda, zvakaita sezera rako, hutano hwako, uye zviratidzo, kuti asvike pamhedziso.

Zvinotora nguva yakareba sei kuti uzive mhedzisiro?

Zvinogona kutora mazuva mashoma kuti chiremba wako aongorore zvabuda muongororo yako yeCFR uye akuzivise. Kana zvabuda muongororo yako zviri pamuganhu, chiremba wako angangoda kuzvikurukura nevamwe vanachiremba. Kana zvabuda muongororo yako zvichiratidza njodzi yechirwere chemwoyo, chiremba wako achataurawo newe nezvechirongwa chekuderedza njodzi yako.

Ndinofanira kutaura nachiremba rini?

Kana muine mibvunzo musati maita bvunzo yeCFR, bvunzai chiremba wenyu. Uyewo, kana mukaona zviratidzo zvisingawanzoitiki, migumisiro yakaipa, kana kusagadzikana mushure mekuongororwa , zivisai chiremba wenyu nekukasika.

Mharidzo Yekuenda Nayo Kumba

Bvunzo ye `Coronary Flow Reserve (CFR)` ibvunzo inopa ruzivo rwakakosha nezve hutano hwetsinga dzemwoyo dzinopa ropa kumoyo wako. Inogona kutarisa kana moyo wako uri kuwana ropa rakawanda raunoda kana uchishanda nesimba.

Kuderera kweCFR kunogona kuva chiratidzo chechirwere chemwoyo. Izvi zvinogonawo kupa pfungwa yeramangwana rako renjodzi yekubatwa nechirwere chemwoyo.

Kana paine chausinganzwisisi nezvebvunzo iyi, usatya kubvunza chiremba wako. Vachakutsanangurira zvese uye vachakubatsira kuti bvunzo yacho ive nyore sezvinobvira. Yeuka, kuchengetedza moyo wako kwakakosha zvikuru!

'Chirwere chemwoyo, tsinga dzemwoyo, kugoverwa kweropa, kuongororwa kweCFR, kurwiswa kwemoyo, hutano hwemwoyo, bvunzo dzekurapa