在显著的二次三角管吐患者中,右心室重塑和功能的预后影响
Marlieke F Dietz1, Edgard A Prihadi1,2, Pieter van der Bijl1
1Department of Cardiology (M.F.D., E.A.P., P.v.d.B., L.G., E.G., O.S.v.G., N.A.M., V.D., J.J.B.), Leiden University Medical Center, The Netherlands.
Circulation
|June 13, 2019
概括
有或没有扩张的右心室静脉功能障碍显著恶化了二次三角管吐患者的结果. 早期干预可能对改善这些个体的生存至关重要.
科学领域:
- 心脏病学
- 心声检查
- 心脏外科
背景情况:
- 三回 (TR) 的治疗取决于右心室 (RV) 的大小和功能.
- 在二级TR中进行RV改造仍然不太了解.
- 这项研究旨在确定RV重塑模式及其在显著的二次TR中的预后价值.
研究的目的:
- 在显著的二次TR患者中进行RV重塑的特征.
- 调查不同车辆改造模式的预后影响.
- 根据TR的临床决定进行干预.
主要方法:
- 在1292名具有显著的二次TR的患者中,用于评估VR重塑.
- 根据RV扩张和缩功能定义了四种RV重塑模式.
- 所有原因的死亡率是主要终点,与重塑模式的事件率进行比较.
主要成果:
- 43%的患者患有扩张的RV与静脉功能障碍 (模式4),与男性性别,并发症和症状相关.
- 与模式1 (正常的RV) 相比,模式3 (正常的RV大小,缩功能障碍) 和模式4 (扩张的RV,缩功能障碍) 的5年生存率显著下降.
- 无论扩张情况如何,RV系统功能障碍是不良结果的独立预测因素.
结论:
- 在显著的二次TR中,静脉缩功能障碍是预后不佳的关键决定因素.
- 在已经存在RV缩功能时,RV扩张的存在不会进一步恶化结果.
- 这些发现突显了评估RV缩功能的重要性.
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