在临床实践中,大动脉反的死亡率和发病率. 一项长期后续研究
K S Dujardin1, M Enriquez-Sarano, H V Schaff
1Division of Cardiovascular Diseases, Section of Cardiovascular Surgery, Mayo Clinic and Mayo Foundation, Rochester, MI, USA.
Circulation
|April 13, 1999
概括
严重的大动脉反的保守管理导致死亡率和发病率高于预期. 对于高风险患者来说,迅速考虑手术至关重要,以减少心脏病死亡率.
科学领域:
- 心脏病学 心脏病学
- 心血管医学 心血管医学
- 心声回声图 (Echocardiography) 是一种心声回声图.
背景情况:
- 保守地管理的大动脉反患者的长期预后尚未确立.
- 大动脉反 (AR) 是一种重要的心血管疾病,需要谨慎的管理策略.
研究的目的:
- 在保守的管理下分析严重或中度严重的大动脉反患者的长期结果.
- 在这个患者队列中确定生存和心血管事件的预测因素.
- 评估手术干预对死亡率的影响.
主要方法:
- 通过彩色多普勒心电回声学诊断出大动脉吐的246名患者的回顾性分析.
- 评估10年的死亡率,心力衰竭,大动脉门手术率和心血管事件.
- 多变量分析以确定生存的独立预测因素和手术对心血管死亡率的影响.
主要成果:
- 保守管理导致10年死亡率为34+/-5%和高发病率,其中47+/-6%患有心力衰竭,62+/-4%接受了大动脉门手术.
- 10年后,75+/-3%的患者已经死亡或接受手术,而83+/-3%的患者经历了心血管事件.
- 生存的预测因素包括年龄,功能类,并发症指数,心房动和左心室末缩直径. 手术与心血管死亡率降低有关 (调整后风险比,0.54;P=0.048).
结论:
- 严峻的主动脉反经过保守的管理与过度死亡率和显著的发病率有关,表明严重的疾病预后.
- 在高风险患者中,应考虑立即进行手术,以减轻心脏病死亡率.
- 左心室喷射率和末缩直径是大动脉吐风险分层的关键指标.
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