患有低梯度"严重"大动脉狭窄和保存的喷射分数的患者的结局
Nikolaus Jander1, Jan Minners, Ingar Holme
1Herz-Zentrum Bad Krozingen, Bad Krozingen, Germany. nikolaus.jander@herzzentrum.de
Circulation
|February 16, 2011
概括
患有低梯度严重大动脉狭窄和正常射出分数的患者的结果与中度狭窄患者的结果相似. 这一发现影响了大动脉膜疾病的预后和治疗策略.
科学领域:
- 心脏病学 心脏病学
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
- 膜心脏疾病 膜心脏疾病
背景情况:
- 回顾性研究表明,低梯度严重的大动脉狭窄症 (AS) 表明疾病已晚,预后不佳.
- 这一小组可能受益于早期手术干预.
- 大动脉狭窄症 (SEAS) 中的simvastatin和ezetimibe研究旨在前性地评估这一患者群.
研究的目的:
- 评估患有低梯度严重大动脉狭窄症 (AS) 和正常射出分数的患者的临床结果.
- 为了将他们的预后与中度大动脉狭窄的患者进行比较.
主要方法:
- 在SEAS研究中对1525名无症状患者的前性评估.
- 定义的低梯度严重AS是大动脉面积<1.0 cm2和平均梯度≤40 mm Hg.
- 基于回声心脏学参数的比较结果,包括大动脉事件和心血管死亡.
主要成果:
- 在29%的患者中发现了低梯度的严重AS,在12%的患者中发现了中度AS.
- 在46个月内,大动脉事件发生在48.5%的低梯度严重AS患者中,而44.6%的中度AS患者中 (P=0.37).
- 两组之间没有观察到主要心血管事件或心血管死亡的显著差异.
结论:
- 患有低梯度严重AS和正常射出分数的患者表现出与中度AS患者相似的临床结果.
- 这些发现挑战了对于这种特定的低梯度严重AS亚组的普遍不良预后的概念.
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