Amandla okupompa entliziyo: Masifunde ngqo nge-Ejection Fraction!

Ngaba wakha weva igama elithi 'Ejection Fraction'? Usenokuba ukhe waliva kugqirha wakho okanye kwilungu losapho xa babethetha ngesifo sentliziyo. Enyanisweni yinto ebaluleke kakhulu, kwaye yindlela yokulinganisa impilo yentliziyo yethu. Ngoko ke, namhlanje siza kuthetha ngokweenkcukacha malunga nokuba yintoni le 'Ejection Fraction' kunye nento ethethayo ngempilo yentliziyo yethu.

Yintoni i-Ejection Fraction? Ngamafutshane...

Ngamafutshane, i-Ejection Fraction yindlela yokulinganisa indlela intliziyo yakho epompa ngayo igazi. Ngokuchanekileyo, ngumlinganiselo wegazi okhutshwa kwiigumbi eziphambili (ezibizwa ngokuba zii-ventricles) ezantsi kwentliziyo ngexesha lokubetha ngakunye.

Ukuze sikuqonde oku, masikhumbule ngokufutshane indlela igazi elihamba ngayo entliziyweni:

1. Igazi liqala lingene kwinxalenye ephezulu ngasekunene yentliziyo (oku kubizwa ngokuba yi-'right atrium').

2. Emva koko, ngexesha lokuphumla okufutshane phakathi kokubetha kwentliziyo, eli gazi lidlula kwivalvu lize liqokelele kwigumbi elisezantsi (`left ventricle`) kwicala lasekhohlo lentliziyo.

3. Ngoku, xa le ventricle yasekhohlo izaliswe ligazi, ngentliziyo elandelayo, inxalenye yelo gazi iphonswa iye kumzimba wonke. Ubungakanani begazi eliphonswayo yiloo nto siyilinganisa ngeqhekeza lokukhupha igazi.

Iyintoni iqhezu eliqhelekileyo lokukhupha igazi entliziyweni ephilileyo?

Inxalenye yokukhupha igazi entliziyweni ephilileyo nesebenza kakuhle kufuneka ibe phakathi kwama-50% nama-70% . Oku kuthetha ukuba xa intliziyo ibetha kube kanye, phakathi kwama-50% nama-70% egazi elikwi-ventricle yasekhohlo liphonswa emzimbeni.

Kodwa kukho oku. Abanye abantu banokuba neqhezu eliqhelekileyo lokuphuma kwegazi, kodwa basenokuba nokusilela kwentliziyo. Oku sikubiza ngokuba yi-'Heart Failure with preserved Ejection Fraction (HFpEF)`. Oku kuthetha ukuba nangona iqhezu eliphumayo lilungile, ukusilela kwentliziyo kubangelwa zezinye iingxaki entliziyweni.

Kutheni kubalulekile ukwazi i-Ejection Fraction yam?

I-Ejection Fraction yakho sisalathisi esibalulekileyo sendlela intliziyo yakho esebenza ngayo. I-Ejection Fraction ephantsi idla ngokuthetha ukuba unesifo sentliziyo okanye usesichengeni sokusilela. Ke ngoko, ukwazi eli xabiso kubaluleke kakhulu ekucwangciseni unyango kunye nokujonga imeko yentliziyo yakho.

Ngaba kukho iintlobo ezahlukeneyo ze-Ejection Fraction?

Ewe, olu vavanyo lunokuthathwa ikakhulu kumagumbi asekhohlo nasekunene ('ii-ventricles') zentliziyo.

Inxalenye Yokukhupha I-Ventricular Ejection Fraction (LVEF)

Sidla ngokuthetha ngecala lasekhohlo lentliziyo njenge-Ejection Fraction.I-ventricle yasekhohlo ipompa igazi elineoksijini eninzi kwizitho zomzimba wonke. Ngoko ke, eli xabiso le-'LVEF' linceda ekuqinisekiseni ukuba kukho na ubuthathaka kwicala lasekhohlo lentliziyo, kwaye ukuba kunjalo, bubunzima kangakanani.

Inxalenye Yokukhupha I-Ventricular Yasekunene (RVEF)

Oku kulinganisa ukuba ingakanani igazi elingcolileyo nelingenawo umoya-mpilo elikhutshwa kwi-ventricle yasekunene yentliziyo ukuya emiphungeni (apho i-oksijini ifakwa khona umoya-mpilo). Eli xabiso le-RVEF libalulekile ukuba unentliziyo engasebenzi kakuhle kwicala lasekunene. Nangona kunjalo, le meko ayiqhelekanga njengokungasebenzi kakuhle kwentliziyo kwicala lasekhohlo.

Ithetha ukuthini ixabiso le-Ejection Fraction?

Ngamafutshane, okukhona i-Ejection Fraction yakho iphantsi, kokukhona amandla entliziyo yakho okupompa igazi ebuthathaka. Oku kubonakala kubantu abaneengxaki ezinkulu zentliziyo. Isenokuba sezantsi nakwizigaba zokuqala zokungaphumeleli kwentliziyo. Iindlela zonyango zixhomekeke ekubeni i-Ejection Fraction yakho ikude kangakanani neqhelekileyo.

• Ukuba iphakathi kwama-40% nama-49%: Oku kubizwa ngokuba yi-'mid-range ejection fraction'. Oku kuthetha ukuba amandla okumpompa kwentliziyo aphantsi kancinci kunesiqhelo. Usenokungabi nazo naziphi na iimpawu zokusilela kwentliziyo. Okanye, iimpawu zinokuvela ngexesha lokuzilolonga, njengaxa uzilolonga, kwaye ziphele xa uphumle.
• 39% okanye ngaphantsi: Oku kubizwa ngokuba yi-`Heart Failure with reduced Ejection Fraction (HFrEF)`. Oku kuthetha ukuba amandla okumpompa aphantsi kakhulu kunesiqhelo. Okukhona i-ejection fraction iphantsi, kokukhona umngcipheko weengxaki ezisongela ubomi ezifana nokuma kwentliziyo ngesiquphe (`Cardiac Arrest`). Iimpawu zinokuba nzima kakhulu, kwaye ungaziva ungakhululekanga nokuba uhleli phantsi.

Ngaba ukusilela kwentliziyo (HFpEF) kunokwenzeka nokuba iqhekeza lokukhupha igazi liqhelekile?

Ewe, njengoko besitshilo ngaphambili, kwimeko ebizwa ngokuba yi-'Heart Failure with preserved Ejection Fraction (HFpEF),' intliziyo ipompa igazi elininzi emzimbeni xa ibetha. Nangona kunjalo, ingxaki kukuba inani elipheleleyo legazi eligcinwe kwi-ventricle yasekhohlo liyancipha. Oku kungenxa yokuba izihlunu zentliziyo ziyaqina okanye ziqine, nto leyo enciphisa ubukhulu begumbi. Emva koko, umzimba awukwazi ukupompa igazi elininzi njengoko ulifuna.

Usenokuba sengozini yokuphuhlisa i-HFpEF ngenxa yezi zizathu zilandelayo:

• I-Cardiac Tamponade (ukuqokelelana kolwelo olujikeleze intliziyo)
• Isifo seMitha yeCoronary
• Isifo seValve yeNtliziyo
• Igazi elonyukayo

Zithini izizathu zokuncipha kweqhezu lokukhupha igazi?

Iifayibha zemisipha yentliziyo ezisempilweni ziyafuneka ukuze iiventricle zentliziyo zinciphe kwaye zikhuphe igazi. Ukuba kukho imeko eyenza buthathaka okanye yonakalise imisipha yentliziyo, oku kuncipha akwenzeki kakuhle, kwaye ukusebenza kakuhle kokumpompa kuyancipha.

Intliziyo kufuneka isebenze nzima ukuze yenze umsebenzi wayo. Olu xinzelelo longezelelweyo lunokubangela ukuba intliziyo idumbe okanye ivelise izicubu ezibomvu. Oku kwenza kube nzima ukuba amagumbi agcwale ngegazi kwaye aphompe igazi. Nokuba iqhekeza lakho lokukhupha igazi linciphile kancinci, usenokungawuboni umahluko omkhulu ekuqaleni. Kodwa ukuba ukusebenza kwentliziyo yakho kuyehla kancinci kwaye iqhekeza lakho lokukhupha igazi liye lisiba mandundu, ungagula kakhulu.

Zithini iimpawu zeqhezu eliphantsi lokukhupha igazi?

Ngokubanzi , xa iqhekeza lokukhupha liphantsi, kokukhona iimpawu zokusilela kwentliziyo zisiba mandundu. Usenokuba namava anje:

• Ukudideka: Ubunzima bokucinga ngokucacileyo.
• Ukudinwa: Ukuziva udiniwe nokuba usemsebenzini.
• Ukubetha kwentliziyo: Ukuziva ubetha okanye ubetha esifubeni.
• Isicaphucaphu.
• Ukuphelelwa ngamandla: Ubunzima bokuphefumla, ingakumbi xa ulele phantsi.
• Ukugcinwa kwamanzi: Imeko apho isisu okanye imilenze idumba ngamanzi.
• Ubuthathaka.

Khumbula, ukuba unale mpawu, kubaluleke kakhulu ukufuna ingcebiso kagqirha ngokukhawuleza.

Kuthekani ukuba i-Ejection Fraction iphezulu kunesiqhelo?

Kunqabile kakhulu ukuba iqhekeza lokukhupha igazi libe yi-75% okanye ngaphezulu. Kodwa ukuba liyenzeka, linokuba yingozi. Oku kunokwenzeka kubantu abaneengxaki ezifana ne-'Hypertrophic Cardiomyopathy' (ukuqina okungaqhelekanga kwemisipha yentliziyo).

Ngubani iqhezu lokukhupha elifanele lilinganiswe?

Ukuba unesifo okanye umngcipheko onokubangela ukungasebenzi kwentliziyo, ukwazi ukuba iqhekeza lakho lokukhupha igazi liphuma emzimbeni luncedo kakhulu. Kwiimeko ezinje ngezi:

• Izifo ezifana ne-'ATTR Amyloidosis' ezichaphazela intliziyo.
• Ezinye iindlela zonyango ze-chemotherapy zomhlaza okanye ezinye izifo zinokubangela umonakalo entliziyweni (i-cardiotoxicity).
• Isifo sentliziyo esizalwa naso.
• Ukuba unesifo sentliziyo.
• Isifo seValve yeNtliziyo.
• I-Myocarditis.
• Uxinzelelo lwegazi oluphezulu kakhulu.
• Ukubetha kwentliziyo okungaqhelekanga kwamagumbi entliziyo (`Ventricular Arrhythmia`).

Isetyenziswa njani i-Ejection Fraction kunyango?

Eli xabiso linceda oogqirha ukuba bakhethe unyango lokusilela kwentliziyo olulungele wena. Kwakhona, ukujonga iqhekeza lakho lokukhupha igazi rhoqo ngexesha lonyango lwakho kunokunceda ekuqinisekiseni ukuba ukusebenza kwentliziyo yakho kuyaphucuka na.

Ezinye zezona ndlela ziphambili zonyango lokuhlaselwa yintliziyo zezi:

• Uhlobo olukhethekileyo lwe-pacemaker (`i-Biventricular pacemaker`).
• Amayeza okuthintela ukungaphumeleli kwentliziyo.
• Ukufakelwa kwentliziyo.
• Ukulungiswa okanye ukutshintshwa kwevalvu yentliziyo.
• Ukufakelwa kwesixhobo esincinci emzimbeni esizisa ukubetha kombane okungxamisekileyo entliziyweni (Implantable Cardioverter Defibrillator - ICD).

I-Ejection Fraction ilinganiswa njani?

Kukho iindlela ezahlukeneyo zokulinganisa iqhezu lokukhupha igazi. Uvavanyo olusetyenziswa kakhulu yi-echocardiogram, efana ne-ultrasound scan yentliziyo.

Ukongeza, ezi mvavanyo zinokulinganisa iqhezu lokukhupha:

• Ukulungiswa kweCatheter yentliziyo.
• Iskeni yentliziyo ethi `CT` (`Cardiac Computed Tomography (CT) scan`).
• I-MRI yentliziyo.
• Iskeni ye-`MUGA` (`Iskeni yoKufumana izinto ezininzi`), ekwabizwa ngokuba yi-`Uvavanyo loXinzelelo lweNyukliya`.

Ndingayiphucula na i-Ejection Fraction yam?

Ewe, ngokuqinisekileyo. Unyango lokungaphumeleli kwentliziyo lunyanga unobangela oyintloko weqhezu eliphantsi lokukhupha igazi. Umzekelo, ukuba iqhezu eliphantsi lokukhupha igazi libangelwa kukubetha kwentliziyo okungahambelaniyo (i-arrhythmia), i-biventricular pacemaker inokubonelela ngoncedo. Ukuba kungenxa yezinye izizathu, ezinje ngoxinzelelo lwegazi oluphezulu, amayeza anokufuneka.

Kwakhona, ungenza oku kulandelayo ukunciphisa uxinzelelo entliziyweni yakho kwaye ufumane okuninzi kunyango lwakho:

• Ukwandisa umsebenzi womzimba: Inkqubo yokuvuselela intliziyo inokukunceda uqalise ukuzilolonga ngokukhuselekileyo.
• Ukugcina ubunzima obusempilweni.
• Ukunciphisa ityuwa (i-sodium) kunye nolwelo ekutyeni.
• Ukuyeka imikhwa emibi efana nokutshaya, iziyobisi kunye notywala.

Ndingazi njani ukuba i-ejection fraction yam iyaphucuka?

Ukuba iqhekeza lakho lokukhupha liphantsi, kuya kufuneka ubone ugqirha wakho rhoqo ukuze alijonge. Kubalulekile ukuya kuzo zonke iintlanganiso zonyango, nokuba awuziva ugula.

Ukuba iimpawu zakho ziyaphucuka, oko kungaba luphawu lokuba iqhekeza lakho lokukhupha igazi liyaphucuka. Nangona kunjalo, iimpawu zakho zinokuba mandundu okanye kuvele iimpawu ezintsha. Ezi zinokubonisa ukuba iqhekeza lakho lokukhupha igazi liya lisiba mandundu.

Ukuba kwenzeka into efana nale, yazisa ugqirha wakho ngoko nangoko, ngaphandle kokulinda idinga likagqirha wakho olandelayo:

• Ubunzima bokuphefumla, ingakumbi xa ulele phantsi.
• Ukuziva ukubetha kwentliziyo ngokukhawuleza ngendlela engaqhelekanga.
• Ukuphelelwa ngumdla wokutya okanye ukuhlanza.
• Ukutshintsha kobunzima ngequbuliso (oku kusenokuba kubangelwa kukugcinwa kwamanzi).
• Ubuthathaka okanye isiyezi sivakala ngaphandle kwesizathu.

I-Ejection Fraction kufuneka ilinganiswe kangaphi?

Oogqirha banokuxhalaba malunga neqhekeza lakho lokukhupha igazi kwezi meko zilandelayo:

• Ukuba uneempawu zokusilela kwentliziyo.
• Ukuba unesifo sentliziyo okanye esinye isifo esichaphazela ukusebenza kwentliziyo.
• Ukuba unesifo esithile esibangela ukuba ube sengozini yokuba nesifo sentliziyo.

Ukuba kufuneka wenze olu vavanyo kangaphi emva kokuba ufunyaniswe ukuba unentliziyo engasebenzi kakuhle kuxhomekeke kwizinto ezininzi, kuquka nokuba i-ejection fraction yakho yokuqala iphantsi kangakanani. Ukuba i-ejection fraction yakho iyaqhubeka nokuba mandundu, kunokufuneka uyihlole rhoqo. Ukuba izinzile, kunokufuneka ungavavanywa rhoqo.

Ngaba i-Ejection Fraction kuphela kovavanyo lokuvavanya imeko yokusilela kwentliziyo?

Hayi. I-ejection fraction yenye nje yeendlela ezininzi zokulinganisa ezisetyenziswa ngoogqirha ukuvavanya imeko yentliziyo yakho. Kufuneka uvavanyo olongezelelweyo ukuze kuchongwe unobangela wemeko yakho kwaye kukunike unyango olufanelekileyo.

Olu vavanyo longezelelweyo lungabandakanya:

• I-Angiography.
• I-X-ray yesifuba.
• I-Echocardiogram.
• I-Electrocardiogram (`I-Electrocardiogram - EKG`).
• Uvavanyo loxinzelelo lomzimba.

Okokugqibela, izinto ekufuneka uzikhumbule (Umyalezo Wokuya Ekhaya)

I-Ejection Fraction luphawu olubalulekileyo lwamandla entliziyo. Ilinganisa ukuba intliziyo ikhupha igazi elingakanani na elineoksijini emzimbeni ngokubetha ngakunye. I-ejection fraction ephantsi idla ngokuba luphawu lokusilela kwentliziyo. Kodwa ungakhathazeki. Ngonyango olufanelekileyo kunye notshintsho kwindlela ophila ngayo, kunokwenzeka ukubuyisela i-ejection fraction yakho kwisimo esiqhelekileyo. Eyona nto ibalulekileyo kukulandela imiyalelo kagqirha wakho kwaye uye rhoqo kwiimvavanyo kunye namadinga. Oku kuya kunceda kakhulu ekugcineni intliziyo yakho isempilweni.

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Iqhekeza Lokukhupha Umzimba, Uhlaselo Lwentliziyo, Impilo Yentliziyo, I-LVEF, I-RVEF, Iimpawu Zentliziyo, Unyango Lwentliziyo