严格的限制性无缘整形对于功能性 mitrale 排泄会导致功能性 mitrale 狭窄和肺高血压吗?
Satoshi Kainuma1, Kazuhiro Taniguchi, Takashi Daimon
1Department of Cardiovascular Surgery, Japan Labor Health and Welfare Organization Osaka Rosai Hospital, Sakai, Osaka, Japan.
Circulation
|September 14, 2011
概括
针对功能性 mitrale 排泄而进行的限制性 mitrale 解剖手术可能会导致功能性 mitrale 狭窄. 然而,手术后的残留性肺高血压与左心室功能障碍有关,而不是 mitra 狭窄,并预测心脏不良事件.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 心血管成像 - 心血管成像
背景情况:
- 针对功能性额外外 (MR) 的限制性额外外 (RMA) 可能导致功能性额外外狭窄 (MS).
- 关于RMA对MS和随后的肺高血压 (PH) 的影响仍在争论中.
- 研究RMA,MS和PH之间的关系对于患者的治疗结果至关重要.
研究的目的:
- 为了评估功能性MR的RMA后功能性MS的发病率.
- 为了确定RMA后残留性肺高血压 (PH) 的原因.
- 为了确定RMA后心脏不良事件的预测因素.
主要方法:
- 108名患有LV功能障碍和严重MR的患者接受了RMA.
- 用多普勒回声心脏图和心脏导管检查来评估额头功能,肺动脉压力和肺动脉功能.
- 随访患者以评估术后结果和心脏不良事件.
主要成果:
- RMA导致功能性MS,通过增加压力半程和梯度表示,并减少有效孔径面积.
- 手术后的缩性肺动脉压力 (PAP) 为32±8毫米升.
- 剩余PH与LV功能障碍和肺血管疾病有关,而不是MS,并预测了不良心脏事件.
结论:
- 功能性MR的RMA可以导致功能性MS.
- 在RMA后的残留PH主要是由LV功能障碍和肺血管疾病驱动的.
- 术后PH,而不是功能性MS,是心脏不良事件的主要预测因素.
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