动脉置换后左心室功能变化的临床影响:来自3112名患者的分析
Dai Une1, Laura Mesana1, Vincent Chan1
1From Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, ON, Canada.
Circulation
|August 26, 2015
概括
大动脉置换 (AVR) 的结果取决于手术前的左心室功能. 在AVR后,不完整的LV恢复和假肢患者不匹配会增加死亡率或心力衰竭风险.
科学领域:
- 心脏病学
- 心脏外科
- 心声检查
背景情况:
- 在动脉置换 (AVR) 后评估结果至关重要.
- 手术前的左心室功能显著影响AVR后的预后.
- 了解AVR后的LV恢复和质量变化对于患者的治疗至关重要.
研究的目的:
- 根据手术前 LV 功能确定AVR后的死亡率和心力衰竭相关性.
- 描述 LV 恢复和质量回归的发生率,时间和相关性.
- 细化AVR患者的适应症,时间,预后和随访.
主要方法:
- 对接受AVR的3112名患者进行了回顾性分析.
- 随访临床评估与心声学 (中位数为6.0年).
- 统计分析以确定死亡率,心力衰竭和LV重塑的相关性.
主要成果:
- 在 LV 功能障碍的严重主动脉狭窄症中,低跨主动脉梯度,更长的旁路和假肢患者不匹配与不良结果相关.
- 在 LV 功能障碍的严重主动脉反中,年龄较大和 LV 质量较高被确定为相关因素.
- 恢复与改善存活率和减少心力衰竭有关;质量回归需要2-5年.
结论:
- 在LV功能障碍的患者中,LV恢复不完全,假肢患者不匹配,低门梯度以及AVR后高LV质量增加死亡率/ 心衰竭风险.
- LV 质量回归延长,并受到 LV 末直径和症状的影响.
- 这些发现有助于临床医生优化AVR患者的选择和管理.
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