Isayensi yezokwelapha iye yaqaphela isikhathi eside ukuthi ukuhlala phansi ngemuva kwesigaba se- ST Segment Elevation Myocardial Infarction (STEMI) (ukuhlaselwa kwenhliziyo) kuyingozi enkulu yokufa ekuqaleni. Abantu abahlanganyela ohlelweni oluhlelekile lokuvuselela inhliziyo ngemuva kokuhlaselwa kwenhliziyo, bese beqhubeka nokusebenzisa uma uhlelo oluhlelekile lokuvuselela kabusha luyaziwa, lungcono kakhulu isikhathi eside kunabantu abahlala (noma aba) abangasebenzi.
Yingakho ukuzivocavoca njalo kugcizelelwa odokotela abaphatha iziguli ezine- coronary artery disease (CAD) .
Umqondo wokuthi kungaba khona into enjengokuzivocavoca "okuningi kakhulu" ngemva kokuhlaselwa yinhliziyo entsha. Noma kunalokho, ukubunjwa okusha komqondo omdala - eminyakeni engu-50 edlule izisulu zokuhlaselwa yinhliziyo zazivame ukuphathwa ngamasonto okulala, futhi ngenxa yalokho zivame ukungabi namagciwane okuhlala unomphela. Ukuze kube khona into enjengokuzivocavoca ngokweqile emva kokuhlaselwa kwenhliziyo evuselelwe kabusha ngephepha lokucwaninga elivela ngo-Agasti 2014 eMayo Clinical Proceedings . Leli phepha lisikisela ukuthi, nakuba ukuvivinya umzimba njalo emva kokuhlaselwa kwenhliziyo kunciphise kakhulu ingozi yokufa, izinzuzo zokuzivocavoca zingase ziqale ukuguqula lapho umbhobho othile ufinyelelwa.
Ngokuqondile, abalobi basikisela, abasindile bezinhliziyo eziphuthumayo abagijima okungaphezu kwamakhilomitha angaba ngu-31 ngesonto, noma abahamba ngokuphuthumayo okungaphezu kwamakhilomitha angu-46 ngesonto, banengozi enkulu yokufa kunezigijimi (noma abahamba ngezinyawo) abasebenzisa kancane kunelezo zimali .
(Kodwa-ke, basengcono kangcono kunokusinda kwenhliziyo abasindayo.)
Ubufakazi be-Threshold yokuzivocavoca
Lobu bufakazi buvela ku-National Runners 'Health Study kanye no-National Walkers' Health Study. Lezi zifundo zathatha abahlanganyeli abangaphezu kuka-100 000, abagcwalisa uchungechunge lwemibuzo mayelana nomlando wabo wezokwelapha kanye nemikhuba yokuzivocavoca.
Kulaba bahlanganyeli, abesilisa abangu-924 nabesifazane abangu-631 babika ukuthi babenokuhlukunyezwa kwenhliziyo, futhi laba bekungabantu abafakwe kulolu cwaningo esixoxisana ngalo.
Nakhu abaphenyi abatholile. Ngemuva kokulandelwa iminyaka engaba ngu-10, abahlanganyeli abagijima amakhilomitha angu-8 ngeviki noma bahamba amakhilomitha angu-12 ngesonto (okungenani ibanga umuntu angayifinyelela abalandela ukulandelana kweziqondiso zokuhlaselwa kwenhliziyo), banciphise isifo senhliziyo yabo -ukufa okuhlobene no-21%, uma kuqhathaniswa nabasindile be-heart attack survival. Ukufa kwehliswe ngamaphesenti angu-24 kubantu abagijima ngamamayela angu-8 kuya ku-16 noma bahamba ngamamayela angu-12-23 ngeviki; ngo-50% kulabo abagijima ngamamayela angu-16-24 noma bahamba ngamamayela angu-23-34 ngesonto; futhi ngo-63% wabantu abagijima ngamamayela angu-24-31 noma bahamba ngamamayela angu-34-46 ngeviki.
Kodwa-ke, abasindayo bezinhliziyo abaphumelela ekusebenzeni kwabo, baze bahamba amakhilomitha angaba ngu-31 noma bahambe ngaphezu kwamamitha angu-46 ngeviki, kuphela ukunciphisa ukulahlekelwa okungu-12% abantu "abavele" balandele iziqondiso zokuzivocavoca zamanje. Ngakho-ke, kusukela kulolu cwaningo, kubonakala sengathi ukuzivocavoca okuqhubekayo emva kokuhlaselwa kwenhliziyo kuyinzuzo enkulu - kuze kufike iphuzu. Kodwa ngaphesheya kwalesi sici - uma kubonakala ukuthi isivikelo sokusebenza sifikile - ukuzuza kokufa komsebenzi ngempela kuqala ukuguqula.
Abalobi bomhleli abavela enkampanini efanayo yeMayo Clinical Proceedings babecabanga ukuthi mhlawumbe kukhona into enjengokuthi "ukulimala ngokweqile komzimba," lapho ukuzivocavoca okuningi kunganciphisa empilweni yempilo (mhlawumbe ngokukhiqiza izicubu ezibomvu enhliziyweni futhi ngakho-ke i- cardiomyopathy ). Uma kunjalo, khona-ke kungenzeka kube khona into enjengokuzivocavoca kakhulu, okungenani kubantu abaye bahlaselwa yinhliziyo.
Ingabe Lokhu Kuyiqiniso Ngempela?
Kungaba yiqiniso ukuthi ukwenza umzimba "ngokweqile" ngemuva kokuhlaselwa kwenhliziyo kunganciphisa inzuzo enkulu oyithola ngokuzivocavoca njalo. Kodwa-ke, kunemikhawulo ebalulekile kulolu cwaningo oludinga ukuthi sibeke iziphetho zalo zibe ngumbono.
Okokuqala, lolu cwaningo lwenziwe nge-questionnaire kuphela. Kufanele sithathe izwi labahlanganyeli ngenani lokuzivocavoca abakwenzayo, futhi mhlawumbe okubaluleke nakakhulu, ngenxa yokuthi empeleni bahlaselwa yinhliziyo. (Odokotela ngezinye izikhathi basebenzisa igama elithi "ukuhlaselwa yinhliziyo" ngokungahambisani futhi ngokungaqondile , futhi iziguli zabo zingase zivele ngephutha.) Ngakho ngezinga elithile, ukunemba kwedatha ngokwayo kungabhekwa. Lokhu, okuyiqiniso, ukunciphisa okwenziwe kwanoma yisiphi isifundo sezokwelapha esithembele kuphela kumbuzo wokuthola idatha yayo.
Mhlawumbe okubaluleke nakakhulu ukutholakala okubonakalayo uma umuntu ebuka ithebula lwedatha eshicilelwe nendaba ngokwayo. Kusukela kuleso tafula, kubonakala ukuthi abasindile bezinhliziyo ababalekele ngaphezu kwamamayela angu-31 ngeviki bebancane kakhulu kunabantu abahamba kancane. Eqinisweni, babeneminyaka engu-51 kuphela ubudala. Futhi ngokusobala, babonakala behlaselwa inhliziyo yabo eminyakeni engaba ngu-13 ngaphambi kokuba babhalise kulolu cwaningo, noma (ngokwesilinganiso) beneminyaka engama-38. Abalobi be-athikili abahambisani ngqo nemiphumela yalesi sikhala seminyaka.
Kodwa siyazi ukuthi abantu abanesifo senhliziyo besencane bavame ukuba nesimo se-CAD esicasulayo, futhi isifo senhliziyo yabo singaba ngcono futhi kunzima kakhulu ukuphatha ngaphandle kweziguli ezijwayelekile ezine-CAD. Ngakho-ke, mhlawumbe ukwanda kokufa okubonwe kubantu abagijima ngaphezu kwamamayela angu-31 ngeviki akubangelwa yilokho okusebenzayo. Esikhundleni salokho, mhlawumbe lokhu kwakungabantu abahlukene bedokotela abahlaselwa yinhliziyo.
Okubalulekile
Izihloko ezazisakazwa kabanzi ngenxa yalesi sifundo zithi "Ukuzivocavoca okuningi emva kokuhlaselwa kwenhliziyo kungakubulala!" Nakuba kungase kube yiqiniso ukuthi ukwenza umzimba omkhulu ngemva kokuhlaselwa kwenhliziyo kungase kunganaki izinzuzo zomsebenzi , sidinga ukugcina izinto ezimbalwa engqondweni njengoba sicabanga ngalokho okushiwo lolu cwaningo.
Okokuqala, lolu cwaningo alisho lutho; Kuyinto engaphelele kakhulu ukutadisha ukwenza okungaphezu kokwenza i-hypothesis entsha edingeka ihlolwe ekuhlolweni okuzokwenzeka emtholampilo.
Okwesibili, "umthamo wokuzivocavoca" owawubonakala kulesi sifundo, okungaphezu kwalokhu ukuzivocavoca okungase kube yingozi ngemva kokuhlaselwa yinhliziyo, kukhulu ngempela. Noma ubani ogijima ngaphezu kwamamayela angu-31 noma ohamba ngaphezu kwamamayela angu-46 ngeviki cishe uhlele kabusha impilo yawo yonke emisebenzini yabo yokuzivocavoca. Abambalwa kakhulu abasinda ezinhlungwini zenhliziyo bahlala bezama ukuhlala endaweni eseduze nalapho kukhona khona isizathu sokukhathazeka.
Futhi okubaluleke kakhulu, kungakhathaliseki ukuthi kukhona into enjengokuzivocavoca "okuningi" ngemuva kokuhlaselwa yinhliziyo, lolu cwaningo luqinisekisa futhi ukuthi ukuzivocavoca njalo ngemva kokuhlaselwa yinhliziyo - ngisho namazinga okuvivinya umzimba kakhulu abasinde ekuhlaselweni kwenhliziyo ngeke bazama ukulondoloza - ihlobene nokuthuthukiswa okukhulu kwemiphumela yenhliziyo. Ukuzivocavoca njalo, lolu cwaningo luqinisekisa, lubaluleke kakhulu empilweni yakho emva kokuhlaselwa yinhliziyo.
Imithombo:
Williams PT, Thompson PD. Ukwandiswa kwezifo ze-cardiovascular disease okuhlobene nokuzivocavoca ngokweqile ekusindeni kwenhliziyo. I-Mayo Clin Proc 2014; I-DOI: 10.1016 / j.mayocp.2014.05.006.
O'Keefe JH, Franklin B, Lavie CJ. Ukusebenzisa impilo nokuphila isikhathi eside nokusebenza okuphezulu: Izimo ezahlukene zemigomo ehlukene. I-Mayo Clin Proc 2014; I-DOI: 10.1016 / j.mayocp.2014.07.007.