Injani 'inkxaso' yentliziyo yakho? Masithethe nge 'Coronary Flow Reserve (CFR)'!

Ngaba wakha wazibuza ukuba intliziyo yakho ifumana igazi elongezelelweyo elifunekayo xa ixinezelekile, njengaxa uzilolonga? Intliziyo yethu sisitho esimangalisayo. Ifuna igazi elilungileyo ukuze isebenze ngokufanelekileyo. Yiloo nto siza kuthetha ngayo namhlanje, kwaye ithetha lukhulu ngempilo yentliziyo yakho: `Coronary Flow Reserve` okanye `CFR`. Ungakhathazeki, la magama asenokuvakala eyinkimbinkimbi kancinci, kodwa masiyigcine ilula.

Yintoni i-'Coronary Flow Reserve (CFR)'? Ngamafutshane...

Cinga ngentliziyo yakho njengenjini yemoto. Xa isebenza ngokuqhelekileyo, injini ifuna umlinganiselo othile wepetroli. Kodwa xa unyuka intaba, okanye uhamba ngokukhawuleza, injini ifuna umlinganiselo othile wepetroli, akunjalo? Yiyo loo nto intliziyo yethu injalo. Xa siphumle, intliziyo ifuna umlinganiselo othile wegazi. Kodwa xa sizilolonga, sibaleka, sitsiba, siphakamisa iintsimbi, okanye siphantsi koxinzelelo, intliziyo ifuna ioksijini kunye nezondlo ezingaphezulu . Ukuze kuhlangatyezwane nale mfuno ikhulayo, ukunikezelwa kwegazi entliziyweni kufuneka kwande.

Imithambo yegazi ephambili ethwala igazi entliziyweni ibizwa ngokuba yimithambo yentliziyo . I-Coronary Flow Reserve (CFR) yindlela yokulinganisa ukuba imithambo yakho yentliziyo inokwandisa kangakanani ukunikezelwa kwegazi xa intliziyo ifuna igazi elingakumbi. Kufana nokujonga indawo egciniweyo 'yokunikezelwa' kwentliziyo.

Oku kukwabizwa ngokuba yi-'Myocardial blood flow reserve'. Kuba igazi liphuma kule mithambo yentliziyo ukuya kwimisipha yentliziyo yakho, oko kukuthi, kwimisipha yentliziyo `(Myocardium)` . Ngoko ke ngeli xabiso le-CFR, oogqirha banokuvavanya ukuba ingaba imisipha yentliziyo yakho ifumana igazi elaneleyo na xa ilifuna.

Ibalwa njani le CFR value?

Olu lubalo lulula kakhulu. Kodwa lufuna uvavanyo olukhethekileyo ukuze kwenziwe oku. Ngamafutshane, i-CFR yeyona ndlela iphezulu yokuhamba kwegazi enokugqitha kwimithambo yakho yentliziyo , yahlulwe yindlela eqhelekileyo yokuhamba kwegazi edlula ngayo kuwe xa uphumle, ngaphandle kokuzibhokoxa .

Umzekelo, xa uphumle, intliziyo yakho impompa iimililitha ezili-X zegazi ngomzuzu. Xa uzimisele kakhulu (okanye xa loo meko ibangelwe bubuqhetseba), intliziyo yakho impompa iimililitha ezili-Y zegazi. Emva koko i-CFR = Y / X.

Oku kulapho intliziyo yakho inokupompa igazi elingaphezulu kuneliqhelekileyo.

Kweziphi iimeko apho uvavanyo lwe-CFR lwenziwa khona?

Kukho izizathu ezahlukeneyo zokuba ugqirha angakucebisa uvavanyo lwe-CFR:

• Fumanisa ukuba unesifo semithambo yegazi yentliziyo (CAD): Ngamanye amaxesha iintlungu zesifuba (i-angina), ubunzima bokuphefumlaXa kuvela iimpawu ezinje, olu vavanyo lunceda ekuqinisekiseni ukuba ingaba imbangela kukuvaleka kwemithambo yentliziyo.
• Hlola ubunzulu be-CAD: Oku kubalulekile ukuqonda ukuba ingakanani imithambo yegazi echaphazelekileyo kunye nokuba ingakanani na i-blood flow evalekileyo kumntu osele ene-CAD.
• Xela umngcipheko wokuhlaselwa yintliziyo kwixesha elizayo: Njengoko ixabiso le-CFR lihla, umngcipheko wokuba nesifo sentliziyo okanye esinye isifo sentliziyo kwixesha elizayo unokwanda.
• Linganisa impumelelo yonyango: Olu vavanyo lungasetyenziselwa ukubona ukuba ukuhanjiswa kwegazi entliziyweni kuye kwabuyiselwa na emva konyango oluthile (umz. i-angioplasty, utyando lwe-bypass).

Ithini ixabiso eliphakathi le-CFR?

I-CFR yomntu ophilileyo idla ngokuba phakathi kwe-2.0 kunye ne-2.5 okanye ngaphezulu . Oku kuthetha ukuba xa usebenza nzima, intliziyo yakho ifumana ubuncinane ukuhamba kwegazi okuphindwe kabini kunaxa uphumle. Umntu ophilileyo unokuba neli xabiso liphezulu njenge-3. Oku kuthetha ukuba banokukwazi ukwandisa ukuhanjiswa kwegazi labo kathathu.

Olunye uphando lufumanise ukuba abantu abane-CFR engaphezulu kwe-2 baphila ngcono emva kweenyanga ezintandathu emva kokuhlaselwa yintliziyo. I-CFR engaphantsi kwe-2 ibonisa umngcipheko ophezulu wesifo sentliziyo.

Kodwa kubalulekile ukuqonda ukuba eli xabiso "liqhelekileyo" linokutshintsha ngokuhamba kweminyaka. Umntu osemtsha osempilweni unokuba ne-CFR ye-5 okanye i-6. Kodwa nomntu oneminyaka engama-80 ubudala osempilweni unokuba ne-CFR engaphantsi kwe-2. Kwakhona, umntwana oye watyandwa ngenxa yesifo sentliziyo sokuzalwa unokuba ne-CFR ephantsi. Ke ngoko, ugqirha wakho uya kugqiba ukuba i-CFR yakho iqhelekile okanye akunjalo, ngokusekelwe kwimpilo yakho iyonke kunye nezinye izinto.

Ungenza njani uvavanyo lwe-CFR? Ungayilungiselela njani?

Kukho iindlela ezimbini eziphambili zokulinganisa i-CFR. Enye yindlela yokungena emzimbeni , ebandakanya ukufaka into emzimbeni. Oku kubandakanya into ebizwa ngokuba yi-'Cardiac Catheterization'. Enye yindlela engangeni emzimbeni , ebandakanya ukusebenzisa i-'Nuclear Stress Test' ekhethekileyo, eyi-'Rubidium-82 Positron Emission Tomography (PET) scan'. Amaxesha amaninzi, i-'Magnetic Resonance Imaging (MRI) scan' ingasetyenziselwa le njongo.

Ngoku makhe sibone indlela yokulungiselela olu vavanyo kunye noko kwenzekayo ngomhla wovavanyo.

Izinto ekufuneka uzazi ngaphambi kovavanyo

• Xelela ugqirha wakho ngamayeza owasebenzisayo: kuquka amayeza abhalwe ngugqirha, amayeza athengiswa ngaphandle kwemvume kagqirha, kunye neevithamini.Ufanele uxelele ugqirha wakho ngazo naziphi na iimveliso zezityalo ozisebenzisayo, kuba amanye amayeza anokuchaphazela ukujikeleza kwegazi.
• Sixelele nge-allergies zakho: Ukuba unayo nayiphi na i-allergies kwimithi, idayi yokwahlulahlula esetyenziswa kwiimvavanyo, okanye i-latex, sazise kwangaphambili.
• Ingcebiso Yokutya Neziselo: Ukuba uxilongwa nge-cardiac catheterization okanye nge-PET scan, buza ugqirha wakho ukuba kufuneka uyeke ukutya okanye ukusela iiyure ezingaphi ngaphambi kovavanyo. Ngokwesiqhelo, awuyi kuvunyelwa ukuba utye okanye usele nantoni na kangangeeyure ezi-6 ukuya kwezi-8 ngaphambi kovavanyo.

Yintoni onokuyilindela ngomhla wovavanyo?

• Kwi-MRI scan: Akufanele ube nazo naziphi na izinto zesinyithi (ezifana nobucwebe okanye iiphini zeenwele) emzimbeni wakho. Ezinye izixhobo zonyango (ezifana ne-pacemakers) zisenokungahambelani ne-MRI. Ngoko ke ukuba unesixhobo esinjalo, cela ugqirha wakho kwangaphambili ukuqinisekisa ukuba sikhuselekile kwi-MRI.
• Ukucoca Intliziyo: Kule nkqubo, kufakwa ityhubhu encinci kakhulu (i-catheter) ngemithambo yegazi entanyeni, emathunjini, okanye engalweni kwimithambo yegazi yentliziyo yakho. Uza kunikwa isithomalalisi esithambileyo ukuze ungaziva ungakhululekanga.
• Umgca we-IV: Nokuba yeyiphi na indlela yovavanyo, "umgca we-Intravenous (IV)" uya kuqhagamshelwa kumthambo osengalweni yakho. Le IV kulapho kunikwa khona amayeza (i-vasodilator) ukuze kuphuculwe ukuhamba kwegazi ukuya entliziyweni kwaye ngamanye amaxesha "idayi yokungafani" ukuze imithambo yentliziyo ibonakale ngakumbi. Ukuba wenza "i-PET scan", into ene -radioactive "iRadiotracer" nayo inikwa ngale IV.

Makhe ndicacise ngakumbi malunga nendlela i-CFR elinganiswa ngayo...

Ugqirha wakho uza kusebenzisa iindlela ezahlukeneyo zokuthatha imifanekiso ukulinganisa ukuhamba kwegazi kwimithambo yakho yentliziyo xa uphumle kwaye ngexesha lokuzivocavoca kakhulu. Ezona ziphambili zezi:

• `I-PET scan`: Kule meko, xa i-`Radiotracer` enikwe nge-IV ifikelela entliziyweni, imiqondiso ekhutshwa yiyo ithathwa yikhamera ekhethekileyo, kwaye ngoncedo lwekhompyutha, kufunyanwa imifanekiso ecacileyo yokuhamba kwegazi entliziyweni.
• ` I-MRI yentliziyo` : Le ikwayindlela yokufota. Nangona kunjalo, ayisetyenziswa rhoqo ukulinganisa i-CFR.

Kubaluleke kakhulu ukuba uhlale ungashukumi ngexesha lokuskena, kungenjalo imifanekiso efunyenweyo isenokungacaci.

Indlela ye-`Cardiac Catheterization` yahlukile kancinci. Ibandakanya:

1. Emva kokuba i-catheter ifakiwe kwi-coronary artery, intambo ekhethekileyo idlula kuyo. Kwincam yale ntambo kukho i-'Ultrasound transducer' (isixhobo esincinci esikhupha kwaye sifumane amaza e-ultrasound). Oku kunokulinganisa isantya sokuhamba kwegazi ngaphakathi kwi-coronary artery.

2. Ngexesha lale nkqubo, iyeza elibizwa ngokuba yi-'Heparin' linikwa nge-IV ukuthintela ukujiya kwegazi.

3. Kukho ezinye iintlobo zeengcingo ezilinganisa ukuhamba kwegazi kusetyenziswa izinzwa zobushushu ezimbini kunye nenaliti yesaline.

Kwenzeka ntoni kanye kanye ngexesha lovavanyo?

Ngexesha lovavanyo lwakho, iqela lezonyango liza kwenza oku kulandelayo:

1. Okokuqala, ukuhamba kwegazi kwimithambo yakho yentliziyo kulinganiswa ngelixa uphumle .

2. Emva koko, uhlobo lweyeza elithi `Vasodilator` (njenge `Adenosine (Adenocard® okanye Adenoscan®)`) lunikwa nge-IV yakho, nto leyo enyusa izinga lentliziyo kunye nokuhamba kwegazi. Eli yeza linyusa ukuhamba kwegazi izihlandlo ezine ukuya kwezihlanu xa kuthelekiswa nexesha ophumle ngalo. Kuthatha ixesha elifutshane, malunga nemizuzu emibini ukuya kwemithathu, ukuba eli yeza lisebenze. Oku kubizwa ngokuba yi `Cardiac Catheterization`, kwaye ngamanye amaxesha eli yeza linokunikwa nge-catheter endaweni ye-IV.

3. Emva kokuba ichiza linikwe, ukuhamba kwegazi kwimithambo yentliziyo kuyalinganiswa kwakhona. Olu luhamba kwegazi oluphezulu.

4. Okokugqibela, ixabiso lakho le-`Coronary Flow Reserve (CFR)` libalwa ngokuthelekisa olu hambo lwegazi luphezulu kunye nohambo lwakho lwegazi oluphumlileyo .

Kwenzeka ntoni emva kovavanyo?

• Ukuba ufake i-catheter (ingakumbi kwi-groin okanye engalweni), kuya kufuneka ugcine indawo yokusikwa ime nkqo kangangeyure okanye ngaphezulu ukuze uthintele ukopha.
• Ugqirha wakho angakuxelela ukuba usele amanzi amaninzi ukunceda ukususa idayi yomahluko emzimbeni wakho.
• Ukuba unikwe iyeza lokuthomalalisa ingqondo, awuyi kukwazi ukuqhuba ngaloo mini. Ngoko ke, kuya kufuneka uze nomntu oza kukuthatha akuse ekhaya .

Zithini iingozi kunye neziphumo ebezingalindelekanga zolu vavanyo lwe-CFR?

Uvavanyo lwe-CFR ludla ngokuba yinkqubo ekhuselekileyo, kodwa njengayo nayiphi na inkqubo yezonyango, kukho iingozi ezincinci.

• Ngenxa yokuba ii-catheters kunye neentambo zifakwa kwimithambo yentliziyo, kunqabile ukuba igazi lijijeke, kuqhekeke imithambo, okanye kuphume igazi.
• Kukho umngcipheko omncinci kakhulu wokonakala kwemithambo yegazi. Ukuba oku kuyenzeka, kunokufuneka utyando ukuze kulungiswe loo mithambo yegazi, kodwa kunqabile kakhulu.

Xa benikwa iyeza elithi `Adenosine`, abanye abantu banokufumana ezi ziphumo zilandelayo, ezihlala imizuzwana embalwa kuphela:

• Isingqisho sentliziyo esingaqhelekanga
• Uxinzelelo lwegazi oluphantsi (iHypotension)
• Ukuqhawukelwa ngumphefumlo
• Ukungonwabi esifubeni

Kubalulekile: I-Adenosine ayinikwa abantu abane-asthma kuba inokubangela i-bronchospasms. Kwiimeko ezinjalo, ugqirha angasebenzisa iyeza elinye le-IV elifana neDobutamine.

Zinjani iziphumo? Zisixelela ntoni?

Uvavanyo lwakho lwe-CFR lukunika inombolo. Eli nani likuxelela ukuba imithambo yakho yentliziyo inokunyusa kangakanani ukuhamba kwegazi ngexesha lokuzilolonga.

Njengoko besikhe sathetha ngaphambili, eli xabiso linokwehla xa umntu ekhula. Umntu osemtsha osempilweni unokuba ne-CFR value engu-5 okanye u-6. Kodwa umntu omdala osempilweni unokuba ne-CFR value engaphantsi kwe-2.

Ukuncipha kokuhamba kwegazi (oko kukuthi, into ebangela umngcipheko) kunokwenzeka nakweyiphi na ixabiso le-CFR eliphakathi kwe-1.6 kunye ne-3.3. Okuqhelekileyo komnye umntu kusenokungabi yinto eqhelekileyo komnye. Ke ngoko, ngugqirha wakho kuphela onokutolika ngokuchanekileyo iziphumo zakho. Uza kuqwalasela izinto ezininzi, ezinje ngobudala bakho, imeko yempilo, kunye neempawu, ukuze afikelele kwisigqibo.

Kuthatha ixesha elingakanani ukwazi iziphumo?

Kungathatha iintsuku ezimbalwa ukuba ugqirha wakho ahlalutye iziphumo zovavanyo lwakho lwe-CFR aze akwazise. Ukuba iziphumo zakho azinamsebenzi, ugqirha wakho unokufuna ukuzixoxa nabanye oogqirha. Ukuba iziphumo zakho zibonisa umngcipheko wesifo sentliziyo, ugqirha wakho uya kuthetha nawe ngesicwangciso sokunciphisa umngcipheko wakho.

Ndingaqhagamshelana nini nogqirha?

Ukuba unemibuzo ngaphambi kokuba uvavanyo lwe-CFR luqale, buza ugqirha wakho. Kwakhona, ukuba ufumana naziphi na iimpawu ezingaqhelekanga, iziphumo ebezingalindelekanga, okanye ukungonwabi emva kovavanyo , yazisa ugqirha wakho ngoko nangoko.

Umyalezo Wokuya Ekhaya

Uvavanyo lwe-`Coronary Flow Reserve (CFR)` luvavanyo olubonelela ngolwazi oluxabisekileyo malunga nempilo yemithambo yentliziyo ehambisa igazi entliziyweni yakho. Lunokujonga ukuba intliziyo yakho ifumana igazi elongezelelweyo elifunekayo xa isebenza nzima.

Ixabiso eliphantsi le-CFR linokuba luphawu lwesifo semithambo yegazi yentliziyo. Linokunika nombono womngcipheko wakho wexesha elizayo wokuhlaselwa yintliziyo.

Ukuba kukho into ongayiqondiyo ngolu vavanyo, ungoyiki ukubuza ugqirha wakho. Baza kukuchazela yonke into baze bakuncede wenze uvavanyo lube lula kangangoko. Khumbula, ukunyamekela intliziyo yakho kubaluleke kakhulu!

"Isifo sentliziyo, imithambo yegazi yentliziyo, ukunikezelwa kwegazi, uvavanyo lwe-CFR, uhlaselo lwentliziyo, impilo yentliziyo, uvavanyo lwezonyango