I-Left Ventricular Dysfunction (LV Ukungasebenzi): Izimpawu, Izimbangela, Ukuxilongwa Nokwelashwa

Inhliziyo isebenza njengendawo yokumpompa umzimba, iqinisekisa ukuthi igazi elinomoya-mpilo lisatshalaliswa kahle kuwo wonke umzimba. I-ventricle yangakwesobunxele, elinye lamagumbi amane enhliziyo, idlala indima ebalulekile kule nqubo. Umsebenzi oyinhloko we-ventricle yesokunxele ukumpompa igazi elinomoya-mpilo ogcwele yonke indawo yomzimba. Uma i-ventricle yangakwesobunxele ingakwazi ukusebenza kahle, kungaholela esimweni sezempilo esaziwa ngokuthi I-Left Ventricular Dysfunction (LV Dysfunction). Lesi simo sezempilo senhliziyo singaba nomthelela omkhulu empilweni yomuntu nasenhlalakahleni yayo yonke. 

Kuyini ukungasebenzi kwe-Left Ventricular (LV Dysfunction)?

I-Left Ventricular Dysfunction, evame ukubizwa ngokuthi i-LV Dysfunction, yisimo lapho i-ventricle yesokunxele yenhliziyo ingafinyeleli ngendlela efanele. Leli khono elincishisiwe lokufinyela nokumpompa igazi ngokuvamile lihlotshaniswa nesifo esibizwa ngokuthi ukuhluleka kwenhliziyo, okungaba yinoma yikuphi ukuhluleka kwenhliziyo ye-systolic noma ukuhluleka kwenhliziyo ye-diastolic. Ukungasebenzi kwe-LV kungabuye kuhlukaniswe ngezinhlobo ezimbili eziyinhloko:

• I-Systolic Heart Failure - Ukungasebenzi kahle kwe-systolic ye-ventricular yesokunxele kubangela ukuthi i-ventricle ibe nenkinga yokufinyela ngokuqinile, okwehlisa ingxenyana yokukhipha, inani legazi i-ventricle elikhipha ngayo ngesigqi ngasinye. Cishe u-55-70% uthathwa njengokuphuma okujwayelekile. Ukungasebenzi kahle kwe-Systolic, okunciphisa amandla enhliziyo okumpompa igazi ngendlela efanele, kuboniswa lapho lehla ngaphansi kwalolu hlu.
• I-Diastolic Heart Failure - Ukungakwazi kwe-ventricle yesokunxele ukuphumula kahle nokugcwalisa ngesikhathi sengxenye ye-diastolic yomjikelezo wenhliziyo kwaziwa ngokuthi ukungasebenzi kahle kwe-diastolic. Lokhu kubangela ukuthi umfutho we-ventricle yesokunxele ukhuphuke futhi ukugcwala kwawo kwe-ventricular kube sengozini.

Izimpawu Zokungasebenzi Kwe-ventricular Kwesokunxele

Izimpawu zokungasebenzi kahle kwe-ventricular yesokunxele zingaba ezicashile ezigabeni zokuqala futhi zingase ziqhubeke ngokuhamba kwesikhathi. Izimpawu ezijwayelekile zokungasebenzi kahle kwe-ventricular kwesokunxele zifaka:

• Ubunzima bokuphefumula kuwuphawu oluvamile lokungasebenzi kahle kwe-ventricular yesokunxele, ikakhulukazi ngemva kokusebenza ngamandla noma ngenkathi isiguli silele sibheke phansi.
• Ukukhathala okungapheli kanye nokuntuleka kwamandla kungase kube izimpawu zokuqala zokungasebenzi kahle kwe-ventricular kwesokunxele, njengoba inhliziyo idonsa kanzima ukuze ihlangabezane nezidingo zomzimba zomoya-mpilo.
• Ukugcina uketshezi kungabangela ukuvuvukala emilenzeni, emaqakaleni nasezinyaweni, isimo esaziwa ngokuthi i-edema. Lokhu kwenzeka ngoba ukungakwazi kwenhliziyo ukumpompa igazi ngendlela efanele kungabangela ukunqwabelana koketshezi emzimbeni.
• Abantu abanokungasebenzi kahle kwe-ventricular kwesokunxele bangase babe nokushaya kwenhliziyo, inhliziyo egijimayo, noma ukushaya kwenhliziyo okungajwayelekile.
• Ezinye iziguli zingase zibe nobuhlungu besifuba, ingcindezi, noma ukungakhululeki, okungaba izimpawu zokuncipha kokunikezwa kwegazi emisipha yenhliziyo.
• A ukukhwehlela okuqhubekayo, ngokuvamile esihambisana nesikhwehlela esinamagwebu noma esibomvana, kungase kube inkomba yokunqwabelana koketshezi emaphashini.
• Labo abahlushwa ukungasebenzi kahle kwe-LV bangase bakuthole kunzima ukuzibandakanya nemisebenzi yomzimba futhi bangase baphelelwe amandla ngesikhathi sokuzivocavoca.

Njengoba isikhathi sihamba, inhliziyo ingase izame ukubuyisela ngokushaya ngamandla amakhulu. Lokhu kuholela ekulimaleni, okungase kubangele okulandelayo:

• Umfutho wegazi ophezulu
• Ukushaya kwenhliziyo okusheshayo
• Inhliziyo ekhulisiwe
• Ukugeleza kwegazi okuncane ukuya ezingalweni nasemilenzeni

Izimbangela Zokungasebenzi Kwe-ventricular Kwesokunxele

Ukungasebenzi kahle kwe-ventricular yesokunxele kungabangelwa yizimbangela ezihlukahlukene. Ezinye izimbangela ezijwayelekile zokungasebenzi kahle kwe-LV zifaka:

• I-Coronary Artery Disease (CAD) - Isizathu esivame kakhulu sokungasebenzi kahle kwe-LV i-CAD, okwenzeka lapho imithambo yenhliziyo ehlinzeka izicubu zenhliziyo incipha/ivinjwa ukunqwabelana kwe-cholesterol noqwembe.
• I-Hypertension (Umfutho Wegazi Ophakeme) - Isikhathi eside umfutho wegazi ophakeme kungaholela ekungasebenzi kahle kwe-LV ngokubangela ukuthi i-ventricle yesokunxele yenhliziyo isebenze kanzima ukumpompa igazi, okuholela ekuqinisweni nasekuqineni kwemisipha yenhliziyo.
• I-Valvular Heart Disease - Izinkinga zamavalvu enhliziyo zingabangela ukungahambi kahle kwegazi lenhliziyo nomfutho, okungase kubangele ukungasebenzi kahle kwe-LV.
• I-Cardiomyopathy - I-Cardiomyopathy yiqembu lezifo zemisipha yenhliziyo ezingenza inhliziyo ibe buthakathaka futhi iholele ekungasebenzi kahle kwe-LV.
• Isifo sikashukela - Imithambo yegazi ingase iqine ngenxa yokwanda kukashukela egazini. Kungaholela ekuqinisweni kwemisipha ngoba kubeka umthwalo omkhulu enhliziyweni.
• Ukukhuluphala ngokweqile - Ukukhuluphala ngokweqile noma ukukhuluphala ngokweqile kwandisa ukucindezelwa kwenhliziyo futhi kungaba nomthelela ekungasebenzini kahle kwe-LV.
• I-Obstructive Sleep Apnea (OSA) - Isiguli esine-OSA sizoyeka ukuphefumula ngenkathi silele. Umzimba uthola uchungechunge oluyinkimbinkimbi lwezinguquko njengomphumela. Lezi zinguquko zibandakanya umfutho wegazi ophakeme, ukuncipha kokunikezwa komoyampilo wenhliziyo, kanye nokuphakama komsebenzi wesistimu yezinzwa. Ukunikezwa kanye nokufunwa komoyampilo akufani ngenxa yalezi zinguquko. Iphinde ikhulise ithuba lokuthuthukisa izifo zenhliziyo ezengeziwe, kuhlanganise nokuhluleka kwenhliziyo ye-diastolic ne-systolic.
• Isifo sezinso - Isifo sezinso esingamahlalakhona singase siholele esimweni sokugcina uketshezi kanye nokwanda kokuqina kwenhliziyo.
• Umlando Womndeni - A umlando womndeni wesifo senhliziyo kungase kwenyuse ingozi yokuthuthukisa Ukungasebenzi Kwe-LV.
• Ubudala - Njengoba abantu bekhula, ubungozi bokungasebenzi kahle kwe-LV buyanda njengoba inhliziyo iba nezinguquko zemvelo.
• Indlela yokuphila yokuhlala - Noma ubani opholile usengozini enkulu yokukhuluphala ngokweqile, isifo sikashukela, isifo senhliziyo, nomfutho wegazi ophakeme. Noma yikuphi kwalokhu kuphazamiseka kungabangela ukwehluleka kwenhliziyo ye-diastolic noma ukungasebenzi kahle kwe-LV.

Ukuhlola Ukuhlonza Ukungasebenzi Kwe-ventricular Kwesokunxele

Ukuhlola okuningana nezinqubo ngokuvamile zisetshenziswa ukuze kuqinisekiswe ukuba khona kokungasebenzi kahle kwe-LV futhi kunqunywe umsuka wayo. Lawa mathuluzi okuxilonga angafaka:

• I-Echocardiogram - An bhequza, noma i-cardiac ultrasound, isebenzisa amaza omsindo ukuze kwakhe izithombe ezinemininingwane yokwakheka nokusebenza kwenhliziyo. Ingakwazi ukuhlola usayizi wamagumbi enhliziyo, ingxenye ye-ejection, kanye nokuba khona kwanoma yikuphi ukungahambi kahle kwama-valve.
• I-Electrocardiogram (ECG noma EKG) - I-ECG irekhoda umsebenzi kagesi wenhliziyo, esiza ekuboneni noma yiziphi izigqi zenhliziyo ezingavamile noma amaphethini.
• I-MRI yenhliziyo (i-Magnetic Resonance Imaging) - I-MRI yenhliziyo inikeza izithombe ezinemininingwane yenhliziyo, okuvumela ukuhlolwa okujulile kwesakhiwo nokusebenza kwenhliziyo.
• Ukuhlolwa Kwelebhu - Ukuhlolwa kwegazi nomchamo kungase kwenziwe ukuze kubhekwe izimo ezingase zibe engozini impilo yenhliziyo. Ukuhlolwa kungenziwa ukuze kuhlolwe ukusebenza kwesibindi nezinso, ushukela wegazi, namazinga e-cholesterol.
• I-Cardiac Catheterization - Kule nqubo yokuhlasela, kufakwa ishubhu elincanyana, eliguquguqukayo (i-catheter) emithanjeni yegazi yenhliziyo ukuze kukale umfutho, kuthathwe amasampula, nokuhlola ukugeleza kwegazi.
• Ukuhlolwa Kwengcindezi - Ukuhlolwa kokucindezeleka, okuhlanganisa ukuhlolwa kokucindezeleka kokuvivinya umzimba noma ukuhlolwa kokucindezeleka kwemithi, kungahlola ukuthi inhliziyo isabela kanjani ekukhuleni komsebenzi owandayo futhi ibone noma yiziphi izindawo zokugeleza kwegazi okuncishisiwe.

Ukwelashwa Kokungasebenzi Kwe-Ventricular Yesokunxele

Ukwelashwa kokungasebenzi kahle kwe-ventricular yesokunxele kungabandakanya inhlanganisela yokuguqulwa kwendlela yokuphila, imithi, kanye nokuhlinzwa kokwelashwa kokungasebenzi kahle kwe-ventricular kwesokunxele:

Ukuguqulwa kwendlela yokuphila:

• Ukudla okunempilo okunosawoti omncane kanye namafutha agcwele kungasiza ekulawuleni ukungasebenzi kahle kwe-LV. Ukunciphisa ukudla kwe-sodium kubalulekile ukuvimbela ukugcinwa koketshezi.
• Ngokuvamile umsebenzi ngokomzimba, ngokwesiqondiso somhlinzeki wezokunakekelwa kwempilo, ingathuthukisa impilo yenhliziyo kanye nempilo yonke.
• Ukucindezeleka enhliziyweni kungancishiswa ngokuzuza nokugcina isisindo esinempilo.
• Ukuyeka ukubhema kubalulekile empilweni yenhliziyo nemithambo yegazi.
• Ukubhekana nokusetshenziswa kabi kwezidakamizwa kanye nokuphuzwa kotshwala ngokweqile kubalulekile.

Imithi:

• Ama-diuretics asiza ukunciphisa ukugcinwa koketshezi ngokugqugquzela ukuphuma koketshezi oluningi ngezinso.
• I-ACE Inhibitors noma ama-ARB angasiza ukukhulula imithambo yegazi nokwehlisa umfutho wegazi.
• Ama-Beta-blockers anciphisa umthwalo enhliziyweni ngokunciphisa izinga lokushaya kwenhliziyo.
• Ama-Calcium Channel Blockers angasiza ukuphumuza imithambo yegazi nokwehlisa umfutho wegazi.
• I-Digoxin ingase isetshenziselwe ukuthuthukisa ukusebenza kwenhliziyo nokulawula izinga lokushaya kwenhliziyo.
• Isitha se-mineralocorticoid receptor sisusa uketshezi nosawoti owengeziwe emzimbeni kuyilapho sigcina i-potassium.
• Ukuze unciphise amazinga e-cholesterol futhi unciphise ingozi ye-atherosclerosis, odokotela bangase banikeze ama-statins.

Ukuhlinzwa:

• I-Angioplasty & Stent Placement - Ezimeni ze-coronary artery disease, i-angioplasty kanye nokubekwa kwe-stent kungenziwa ukuze kuvulwe imithambo evalekile noma emincane.
• I-Coronary Artery Bypass Grafting (CABG) - Ukuhlinzwa kwe-CABG can i-bypass ivimbe imithambo yenhliziyo ukuthuthukisa ukugeleza kwegazi enhliziyweni.
• Ukulungiswa kwamavalvu noma Ukushintsha - Uma isifo senhliziyo se-valvular sinomthelela ekungasebenzi kahle kwe-LV, ukulungiswa kokuhlinzwa noma ukushintshwa kwamavalvu enhliziyo kungase kudingeke.
• Amadivayisi Afakelwayo - Ezinye iziguli zingazuza kumadivayisi afakelwayo njengama-pacemaker noma ama-defibrillator ukuze alawule isigqi senhliziyo.
• Ukufakelwa Kwenhliziyo - Ezimeni ezinzima zokungasebenzi kahle kwe-LV, ukufakelwa kwenhliziyo kungase kucatshangelwe lapho ezinye izinketho zokwelashwa zingasasebenzi. 

Isiphetho

I-Left Ventricular Dysfunction yisimo esiyinkimbinkimbi futhi esingase sibe yingozi esingaba nomthelela omkhulu kukhwalithi yokuphila komuntu. Ukutholwa kusenesikhathi nokuphatha ngempumelelo kubalulekile ekunikezeni imiphumela engcono kakhulu kulabo abathintekile yilesi simo sezempilo. Njengezimo eziningi zenhliziyo nemithambo yegazi, ukuvimbela kubalulekile, futhi abantu bangathatha izinyathelo ezithile zokunciphisa ubungozi bokuthola ukungasebenzi kahle kwe-LV ngokugcina indlela yokuphila enempilo.

Imibuzo Evame Ukubuzwa

1. Kubi kangakanani ukwehluleka kwe-ventricular kwesokunxele?

Ubukhulu bezimpawu zokuhluleka kwe-LV kanye nembangela eyisisekelo yokuhluleka kwenhliziyo kwesokunxele inquma ukubikezela kwesimo sezokwelapha. Ngemithi kanye nokulungiswa kwendlela yokuphila, abanye bazolulama. Abanye bangase babhekane nokuxilongwa okusongela ukuphila kokuhluleka kwenhliziyo kwesokunxele.

2. Ukubona kanjani ukungasebenzi kahle kwe-ventricular yesobunxele?

Ukuhluleka kwenhliziyo kutholakala ngomtholampilo. Ngaphezu kokuhlola umzimba, udokotela uzobuza ngezimpawu zakho kanye nomlando wezempilo womndeni wakho. Udokotela wakho anga-oda ilebhu ne-imaging test ukuze ahlole inhliziyo yakho uma ekholelwa ukuthi ushiye i-ventricular hypertrophy.

3. Ingabe ukungasebenzi kahle kwe-LV kungelapheka?

Abantu abangenawo isifo se-coronary artery abanokungasebenzi kahle kwe-diastolic ngokuvamile baphila cishe isikhathi esilinganayo njengabantu emphakathini jikelele. Ukwelashwa kungase kube inselele kakhulu uma usuvele unokukhubazeka kwe-diastolic nezinye izimo zenhliziyo, njengesifo se-coronary artery noma ukuhluleka kwenhliziyo ye-systolic.

4. Ungabuyiswa kanjani umsebenzi we-LV?

Ama-defibrillator angamadivayisi asiza ukubuyisela ukusebenza kwe-ventricular kwesokunxele kokujwayelekile.