在患有严重大动脉吐症的患者中, mitrale regurgitation 的预后影响
Ramdas G Pai1, Padmini Varadarajan
1Division of Cardiology, Loma Linda University Medical Center, Loma Linda, CA 92354, USA. ramdaspai@yahoo.com
Circulation
|September 15, 2010
概括
副心脏反 (MR) 在严重的大动脉反 (AR) 中很常见. 通过大动脉置换 (AVR) 和中枢修复治疗MR改善了这些患者的生存率.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
背景情况:
- 严重的大动脉反 (AR) 经常与 mitrale 反 (MR) 一起发生.
- 严重AR患者中MR的临床和预后影响尚未得到充分证实.
- 磁力共振可能导致心房动,心力衰竭,并在大动脉置换 (AVR) 期间需要进行心心膜手术.
研究的目的:
- 调查严重主动脉反 (AR) 患者中肌反 (MR) 的患病率和预后意义.
- 评估大动脉置换 (AVR) 和同时进行的 mitra 门修复对该患者队列的生存的影响.
主要方法:
- 在1993年至2007年期间,对756名患有严重AR的患者进行了回顾性分析.
- 审查了心声学数据和临床信息.
- 从国家死亡指数获得死亡率数据,并根据MR严重程度进行分析.
主要成果:
- 45%的严重AR患者有中度至严重的MR (等级≥2+).
- 随着MR严重程度的增加,生存率逐渐下降 (P<0.0001).
- 动脉置换 (AVR) 与同时修复 mitra 与 3+ 或 4+ MR (HR 0.29,P=0.02) 的患者的生存率改善有关.
结论:
- 中度至重度的甲状腺反 (MR) 在严重的大动脉反 (AR) 中普遍存在,并独立预测降低生存率.
- 大动脉置换 (AVR) 和同时进行的 mitra 门修复显著改善了生存结果.
- 严重AR患者中MR的发展应促使考虑AVR,即使在无症状个体中也是如此.
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