手術によるリバスカライゼーションを受けている患者における中程度の機能性ミトラ不全の影響
Eugene A Grossi1, Gregory A Crooke, Paul L DiGiorgi
1Department of Cardiothoracic Surgery, New York University School of Medicine, New York, NY 10028, USA. grossi@cv.med.nyu.edu
Circulation
|July 6, 2006
まとめ
軽度および中等度のミトラル反発 (MR) は,左心室機能に関係なく,冠動脈バイパス移植 (CABG) の後の生存率を著しく低下させます. CABG中にMRを訂正することで結果が改善されるかどうかを判断するために,さらなる研究が必要である.
科学分野:
- 心血管外科手術についてです.
- 心臓外科手術の結果について
- ミトラルバルブ病の症状について
背景:
- 冠動脈バイパス移植 (CABG) を受けている患者における機能的ミトラル反発 (MR) は,アウトカムに関する臨床的不確実性を提示します.
- 軽度から中等度のMRと左心室機能不全がアウトカムに与える影響は十分に理解されていません.
研究 の 目的:
- CABGを単離したCABGで受けている,より軽度の機能性ミトラル吐症の患者における早期および遅いアウトカムを調べる.
主な方法:
- 隔離CABG (1996年-2004年) を受けた2242人の患者さんからの将来的なデータ収集.
- ミトラル反吐 (MR) とエジェクション分数 (EF) の定量化;社会保障死亡給付指数で評価された長期生存率.
主要な成果:
- 37.5%はMRなし,50.7%は軽度MR,11.8%は中度MRでした.
- 適度なMR患者は高齢で,女性の方が多く,腎疾患,前発心筋梗塞,閉塞性心不全,およびEF値の低下率が高かった.
- 生存率の低下は,中等度 MR (expbeta=1.49; P=0.007) と軽度 MR (expbeta=1.34; P=0.033) と独立して,心室機能に関係なく関連していました.
結論:
- 軽度および中度機能性ミトラル反吐は,CABG後の生存率低下の独立した予測因子である.
- CABG中に適度な機能的なMRを修正する利点については,さらなる調査が必要です.
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