Ikhono lokupompa lenhliziyo: Ake sifunde ngqo nge-Ejection Fraction!

Wake wezwa igama elithi 'Ingxenye Yokukhumula'? Kungenzeka ukuthi uke wezwa kudokotela wakho noma ilungu lomndeni lapho bekhuluma ngesifo senhliziyo. Empeleni kuyinto ebaluleke kakhulu, futhi kuyisilinganiso sokuthi inhliziyo yethu iphilile kangakanani. Ngakho-ke, namuhla sizoxoxa ngokuningiliziwe ngokuthi iyini le 'Ngxenye Yokukhumula' nokuthi ithini ngempilo yenhliziyo yethu.

Iyini i-Ejection Fraction? Kalula nje...

Kalula nje, i-Ejection Fraction iyisilinganiso sokuthi inhliziyo yakho ipompa kahle kangakanani igazi. Ngokuqondile, inani legazi elikhishwa emakamelweni amakhulu (abizwa nangokuthi ama-ventricles) phansi kwenhliziyo ngesikhathi sokushaya ngakunye.

Ukuze siqonde lokhu, ake sikhumbule kafushane ukuthi igazi ligeleza kanjani enhliziyweni:

1. Igazi liqala lingene engxenyeni engenhla kwesokudla yenhliziyo (lokhu kubizwa ngokuthi 'i-atrium efanele').

2. Bese kuthi, ngesikhathi sokuphumula okufushane phakathi kokushaya kwenhliziyo, leli gazi lidlula nge-valve bese liqoqana ekamelweni elingezansi (`i-ventricle yangakwesobunxele`) ohlangothini lwesobunxele lwenhliziyo.

3. Manje, lapho le ventricle yesobunxele igcwele igazi, ngokushaya kwenhliziyo okulandelayo, ingxenye yalelo gazi ikhishwa iye kuwo wonke umzimba. Inani legazi elikhishwayo yilokho esikulinganisa ngengxenye yokukhipha igazi.

Iyini ingxenye evamile yokukhipha igazi enhliziyweni enempilo?

Ingxenye yokukhipha igazi yenhliziyo enempilo nesebenza kahle kufanele ibe phakathi kuka-50% no-70% . Lokhu kusho ukuthi uma inhliziyo ishaya kanye, phakathi kuka-50% no-70% wegazi elise-ventricle yesobunxele likhishwa liye emzimbeni.

Kodwa kukhona nalokhu. Abanye abantu bangase babe nengxenye evamile yokukhipha isisu, kodwa bangase babe nokwehluleka kwenhliziyo. Lokhu sikubiza ngokuthi 'Ukwehluleka Kwenhliziyo Okunengxenye Yokukhipha Egcinwe (HFpEF)'. Lokhu kusho ukuthi yize ingxenye yokukhipha isisu ilungile, ukwehluleka kwenhliziyo kubangelwa ezinye izinkinga enhliziyweni.

Kungani kubalulekile ukwazi i-Ejection Fraction yami?

Ingxenye Yakho Yokukhipha Igazi iyinkomba ebalulekile yokuthi inhliziyo yakho isebenza kahle kangakanani. Ingxenye Ephansi Yokukhipha Igazi ivame ukusho ukuthi usengozini yokwehluleka kwenhliziyo noma usengozini yokwehluleka kwenhliziyo. Ngakho-ke, ukwazi leli nani kubaluleke kakhulu ekuhleleni ukwelashwa nokuqapha isimo senhliziyo yakho.

Ingabe kunezinhlobo ezahlukene ze-Ejection Fraction?

Yebo, lokhu kulinganisa kungathathwa ikakhulukazi emakamelweni angakwesobunxele nakwesokudla ('ama-ventricle') enhliziyo.

Ingxenye Yokukhipha I-Ventricular Yesobunxele (LVEF)

Ngokuvamile sikhuluma ngohlangothi lwesobunxele lwenhliziyo njenge-Ejection Fraction. Ngoba,I-ventricle yesobunxele ipompa igazi elinomoya-mpilo eliningi ezithweni zomzimba wonke. Ngakho-ke, leli nani le-'LVEF' lisiza ekunqumeni ukuthi kukhona yini ubuthakathaka ohlangothini lwesobunxele lwenhliziyo, futhi uma kunjalo, ukuthi bukhulu kangakanani.

Ingxenye Yokukhipha I-Ventricular Yangakwesokudla (RVEF)

Lokhu kukala ukuthi lingakanani igazi elingcolile nelingenawo umoya-mpilo elikhishwa lisuka e-ventricle yesokudla yenhliziyo liye emaphashini (lapho umoya-mpilo uphinde ufakwe khona umoya-mpilo). Leli nani le-RVEF libalulekile uma unenhliziyo ehlulekayo ohlangothini lwesokudla. Kodwa-ke, lesi simo asivamile njengokwehluleka kwenhliziyo ohlangothini lwesobunxele.

Kusho ukuthini amanani e-Ejection Fraction?

Kalula nje, uma i-Ejection Fraction yakho iphansi, kulapho ikhono lenhliziyo yakho lokupompa igazi liba buthaka khona. Lokhu kubonakala kubantu abanokwehluleka okukhulu kwenhliziyo. Kungaba futhi kuphansi ezigabeni zokuqala zokwehluleka kwenhliziyo. Izindlela zokwelapha zincike ekutheni i-Ejection Fraction yakho ikude kangakanani nejwayelekile.

• Uma kuphakathi kuka-40% no-49%: Lokhu kubizwa ngokuthi `ingxenye yokukhipha uketshezi ephakathi nendawo`. Lokhu kusho ukuthi ikhono lokupompa kwenhliziyo liphansi kancane kunokuvamile. Ungase ungabi nazo izimpawu zokwehluleka kwenhliziyo. Noma, izimpawu zingase zivele ngezikhathi zokuzikhandla, njengasesikhathini sokuzilolonga, bese ziphela uma uphumula.
• 39% noma ngaphansi: Lokhu kubizwa ngokuthi `Ukwehluleka Kwenhliziyo Okune-Ejection Fraction Encishisiwe (HFrEF)`. Lokhu kusho ukuthi ikhono lokupompa liphansi kakhulu kunejwayelekile. Uma i-ejection fraction iphansi, kulapho ingozi yezinkinga ezisongela impilo njengokuma kwenhliziyo okungazelelwe (`Cardiac Arrest`) iphakama khona. Izimpawu zingaba zimbi kakhulu, futhi ungase uzizwe ungakhululekile ngisho noma uhleli phansi.

Ingabe ukwehluleka kwenhliziyo (HFpEF) kungenzeka noma ngabe ingxenye yokukhipha igazi ijwayelekile?

Yebo, njengoba sishilo ngaphambili, esimweni esibizwa ngokuthi `Ukwehluleka Kwenhliziyo Okune-Preserved Ejection Fraction (HFpEF),` inhliziyo ipompa igazi eliningi emzimbeni uma ishaya. Kodwa-ke, inkinga ukuthi inani eliphelele legazi eligcinwe kwi-ventricle yesobunxele liyancipha. Lokhu kungenxa yokuthi imisipha yenhliziyo iyaqina noma iqine, okunciphisa ubukhulu begumbi. Ngemuva kwalokho, umzimba awukwazi ukupompa igazi eliningi ngendlela olidingayo.

Ungase ube sengozini yokuthola i-HFpEF ngenxa yezizathu ezilandelayo:

• I-Cardiac Tamponade (ukunqwabelana koketshezi oluzungeze inhliziyo)
• Isifo Semithambo Yenhliziyo
• Isifo Se-Valve Yenhliziyo
• Umfutho Wegazi Ophakeme

Yiziphi izimbangela zokuncipha kwengxenye yokukhipha?

Kudingeka imicu yemisipha yenhliziyo enempilo ukuze ama-ventricle enhliziyo afinyele futhi akhiphe igazi. Uma kukhona isimo esenza imisipha yenhliziyo ibe buthaka noma yonakalise, lokhu kufinyela akwenzeki kahle, futhi ukusebenza kahle kokupompa kuyancipha.

Inhliziyo kufanele isebenze kanzima ukuze yenze umsebenzi wayo. Lokhu kucindezeleka okwengeziwe kungabangela ukuthi inhliziyo ivuvuke noma ikhiqize izicubu ezibomvu. Lokhu kwenza kube nzima ngamakamelo ukuthi agcwale igazi futhi ampompe igazi. Ngisho noma ingxenye yakho yokukhipha igazi inciphile kancane, ungase ungaboni umehluko omkhulu ekuqaleni. Kodwa uma ukusebenza kwenhliziyo yakho kwehla kancane kancane futhi ingxenye yakho yokukhipha igazi iba yimbi kakhulu, ungagula kakhulu.

Ziyini izimpawu zengxenye ephansi yokukhipha isisu?

Ngokuvamile , uma ingxenye yokukhipha isisu iphansi, kulapho izimpawu zokwehluleka kwenhliziyo ziba zimbi kakhulu. Ungase ubhekane nezinto ezifana nalezi:

• Ukudideka: Ubunzima bokucabanga kahle.
• Ukukhathala: Ukuzizwa ukhathele ngisho noma usemsebenzini nje.
• Ukushaya kwenhliziyo: Umuzwa wokushaya noma ukushaya esifubeni.
• Isicanucanu.
• Ukuphelelwa umoya: Ubunzima bokuphefumula, ikakhulukazi uma ulele phansi.
• Ukugcinwa kwamanzi: Isimo lapho isisu noma imilenze ivuvukala khona ngamanzi.
• Ubuthakathaka.

Khumbula, uma unalezi zimpawu, kubaluleke kakhulu ukufuna iseluleko sezokwelapha ngokushesha.

Kuthiwani uma i-Ejection Fraction iphakeme kunejwayelekile?

Akuvamile kakhulu ukuthi ingxenye yokukhipha isisu ibe ngu-75% noma ngaphezulu. Kodwa uma kwenzeka, kungaba yingozi. Lokhu kungenzeka kubantu abanezimo ezifana ne-'Hypertrophic Cardiomyopathy' (ukuqina okungajwayelekile kwemisipha yenhliziyo).

Ingxenyana kabani yokukhipha okufanele ilinganiswe?

Uma unesifo noma into eyingozi engabangela ukwehluleka kwenhliziyo, ukwazi ukuthi ingxenye yakho yokukhipha isisu iwusizo kakhulu. Ezimweni ezinjengalezi:

• Izifo ezifana ne-'ATTR Amyloidosis' ezithinta inhliziyo.
• Eminye imithi yokwelapha umdlavuza noma ezinye izifo ingadala umonakalo enhliziyweni (ubuthi benhliziyo).
• Isifo Senhliziyo Esizalwa Naso.
• Uma unesifo senhliziyo.
• Isifo Se-Valve Yenhliziyo.
• I-Myocarditis.
• Umfutho wegazi ophakeme kakhulu.
• Ukushaya kwenhliziyo okungajwayelekile kwamagumbi enhliziyo (`Ventricular Arrhythmia`).

Isetshenziswa kanjani i-Ejection Fraction ekwelapheni?

Leli nani lisiza odokotela ukuthi bakhethe ukwelashwa kokwehluleka kwenhliziyo okungcono kakhulu kuwe. Futhi, ukuhlola ingxenye yakho yokukhipha igazi njalo phakathi nokwelashwa kwakho kungasiza ekunqumeni ukuthi ukusebenza kwenhliziyo yakho kuyathuthuka yini.

Ezinye zezindlela eziyinhloko zokwelapha ukuhlaselwa yinhliziyo yilezi:

• Uhlobo olukhethekile lwe-pacemaker (`i-Biventricular pacemaker`).
• Imithi yokwehluleka kwenhliziyo.
• Ukufakelwa inhliziyo.
• Ukulungiswa noma ukushintshwa kwevalvu yenhliziyo.
• Ukufakelwa kwedivayisi encane emzimbeni eletha ukushaqeka kukagesi okuphuthumayo enhliziyweni (Implantable Cardioverter Defibrillator - ICD).

I-Ejection Fraction ilinganiswa kanjani?

Kunezindlela eziningana zokulinganisa ingxenye yokukhipha igazi. Ukuhlolwa okuvame ukusetshenziswa kakhulu yi-echocardiogram, okufana nokuskena kwenhliziyo nge-ultrasound.

Ngaphezu kwalokho, lezi zivivinyo zingalinganisa nengxenye yokukhipha:

• I-Catheterization Yenhliziyo.
• Ukuskena kwenhliziyo okubizwa ngokuthi ‘CT’ (‘Cardiac Computed Tomography (CT) scan`).
• I-MRI yenhliziyo.
• Ukuskena kwe-`MUGA` (`Ukuskena Kokuthola Okuningi`), okubizwa nangokuthi `Ukuhlolwa Kokucindezeleka Kwenuzi`.

Ngingayithuthukisa yini i-Ejection Fraction yami?

Yebo, impela. Izindlela zokwelapha zokwehluleka kwenhliziyo zelapha imbangela eyisisekelo yengxenyana yokukhipha ephansi. Isibonelo, uma ingxenye yokukhipha ephansi ibangelwa ukushaya kwenhliziyo okungajwayelekile (i-arrhythmia), i-biventricular pacemaker inganikeza impumuzo. Uma kungenxa yezinye izimbangela, njengomfutho wegazi ophakeme, kungadingeka imithi.

Futhi, ungenza okulandelayo ukuze unciphise ukucindezeleka enhliziyweni yakho futhi uthole okuningi ekwelashweni kwakho:

• Ukwandisa umsebenzi womzimba: Uhlelo lokuvuselela inhliziyo lungakusiza ukuthi uqale ukuzivocavoca ngokuphephile.
• Ukugcina isisindo esinempilo.
• Ukunciphisa usawoti (i-sodium) kanye noketshezi ekudleni.
• Ukuyeka imikhuba eyingozi njengokubhema, izidakamizwa kanye notshwala.

Ngingazi kanjani ukuthi ingxenye yami yokukhipha isisu iyathuthuka?

Uma ingxenye yakho yokukhipha isisu iphansi, kuzodingeka ubonane nodokotela wakho kaningi ukuze uyiqaphele. Kubalulekile ukuya kuzo zonke izikhathi zokubonana nodokotela, noma ngabe awuzizwa ugula.

Uma izimpawu zakho ziyathuthuka, kungaba uphawu lokuthi ingxenye yakho yokukhipha isisu iyathuthuka. Kodwa-ke, izimpawu zakho zingase zibe zimbi kakhulu noma kuvele izimpawu ezintsha. Lokhu kungabonisa ukuthi ingxenye yakho yokukhipha isisu iya iba yimbi kakhulu.

Uma kwenzeka into efana nale, yazisa udokotela wakho ngokushesha, ngaphandle kokulinda ukubonana nodokotela wakho olandelayo:

• Ubunzima bokuphefumula, ikakhulukazi uma ulele phansi.
• Ukuzwa ukushaya kwenhliziyo okusheshayo ngendlela engavamile.
• Ukulahlekelwa yisifiso sokudla noma ukuhlanza.
• Ukushintsha kwesisindo ngokuzumayo (lokhu kungase kube ngenxa yokugcinwa kwamanzi).
• Ubuthakathaka noma isiyezi kuzwakala ngaphandle kwesizathu.

I-Ejection Fraction kufanele ikalwe kangaki?

Odokotela bangase bakhathazeke ngengxenye yakho yokukhipha igazi ezimweni ezilandelayo:

• Uma unezimpawu zokwehluleka kwenhliziyo.
• Uma unesifo senhliziyo noma esinye isimo esithinta ukusebenza kwenhliziyo.
• Uma unesifo esithile esikwandisa ingozi yakho yesifo senhliziyo.

Ukuthi kufanele wenze kangaki lokhu kuhlolwa ngemva kokuxilongwa ukuthi une-heart failure kuncike ezintweni eziningana, okuhlanganisa nokuthi ingxenye yakho yokuqala yokukhipha isisu iphansi kangakanani. Uma ingxenye yakho yokukhipha isisu iqhubeka nokuba yimbi, kungadingeka ukuthi uyihlolwe kaningi. Uma izinzile, kungadingeki ukuthi uhlolwe kaningi.

Ingabe i-Ejection Fraction iyona kuphela indlela yokuhlola isimo sokwehluleka kwenhliziyo?

Cha. Ingxenyeni yokukhipha isisu ingenye nje yezilinganiso eziningi odokotela abazisebenzisayo ukuhlola isimo senhliziyo yakho. Kudingeka ukuhlolwa okwengeziwe ukuze kutholakale imbangela eqondile yesimo sakho futhi kukunikeze ukwelashwa okufanele kakhulu.

Lezi zivivinyo ezengeziwe zingafaka:

• I-Angiography.
• I-X-ray yesifuba.
• I-Echocardiogram.
• I-Electrocardiogram (`I-Electrocardiogram - EKG`).
• Ukuhlolwa Kokucindezeleka Kokuzivocavoca.

Okokugcina, izinto okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

I-Ejection Fraction iyinkomba ebalulekile yamandla enhliziyo. Ilinganisa ukuthi inhliziyo ikhipha igazi elingakanani elinomoya-mpilo emzimbeni ngokushaya ngakunye. I-ejection fraction ephansi ivame ukuba uphawu lokwehluleka kwenhliziyo. Kodwa ungakhathazeki. Ngokwelashwa okufanele kanye nokushintsha kwendlela yakho yokuphila, kuvame ukukwenzeka ukubuyisela i-ejection fraction yakho esimweni esijwayelekile. Into ebaluleke kakhulu ukulandela imiyalelo kadokotela wakho futhi uye ezivivinyweni ezivamile kanye nama-aphoyintimenti. Lokhu kuzosiza kakhulu ekugcineni inhliziyo yakho iphilile.

Ingxenye Yokukhipha Umzimba, Ukuhlaselwa Yinhliziyo, Impilo Yenhliziyo, I-LVEF, I-RVEF, Izimpawu Zenhliziyo, Ukwelashwa Kwenhliziyo