通过跨导管大动脉植入引发的左束分支阻塞增加了死亡风险
Patrick Houthuizen1, Leen A F M Van Garsse, Thomas T Poels
1Maastricht University Medical Center, Maastricht, Netherlands.
Circulation
|July 14, 2012
概括
过导管大动脉植入 (TAVI) 可以导致新的左捆支部阻塞 (LBBB),增加死亡风险. 这项研究发现,TAVI诱导的LBBB是严重大动脉狭窄症患者死亡的独立预测因子.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 心脏电生理学 心脏电生理学
背景情况:
- 过导管大动脉植入 (TAVI) 是严重的大动脉狭窄症的关键治疗方法.
- 新发病的左束枝阻塞 (LBBB) 发生在30-50%的TAVI患者中,但其临床影响仍然不确定.
研究的目的:
- 调查TAVI后新发LBBB和全因死亡率之间的关联.
- 为了确定TAVI患者死亡率的预测因素.
主要方法:
- 一个多中心注册表收集了TAVI患者 (2005-2010年) 的数据.
- 在患有新LBBB和没有LBBB的患者之间比较了全因死亡率.
- 多变量回归分析确定了死亡率的独立预测因素.
主要成果:
- 在679名患者中,233人 (34.3%) 在TAVI后出现了新的LBBB.
- 与没有 (24.0%) (P=0.002) 相比,LBBB患者 (37.8%) 的全因死亡率明显高于LBBB患者 (37.8%).
- TAVI诱导的LBBB是死亡率的独立预测因素,除了COPD,女性性别,低射出分数和较高的肌素.
结论:
- 在TAVI后新发的LBBB与所有原因死亡率的增加有关.
- TAVI诱导的LBBB是接受手术的患者死亡的独立风险因素.
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