在患有退行性 mitrale 排泄症的患者中,手术后的 trans-mitral 梯度,正在进行 mitrale 门 transcatheter 边缘到边缘修复
Francesco De Felice1, Luca Paolucci1, Carmine Musto1
1Division of Interventional Cardiology, Azienda Ospedaliera S. Camillo Forlanini, Rome, Italy.
概括
单独使用两管通透管边缘修复 (MV-TEER) 后高的术后平均梯度 (ppMG) 不能预测退行性两管吐 (DMR) 患者的不良事件. 然而,高的ppMG与残留 mitrale 排泄 (rMR) 结合,在一年内强烈预测了负面结果.
科学领域:
- 心血管医学 心血管医学
- 干预心脏病学 干预心脏病学
- 医疗器械技术 医疗器械技术
背景情况:
- 在退行性眼膜反 (DMR) 中,经过两头透管边缘修复 (MV-TEER) 后高术后平均梯度 (ppMG) 的预后意义仍然不清楚.
- 现有研究提出了关于高ppMG和MV-TEER后临床结果之间的关联的相互矛盾的数据.
研究的目的:
- 调查升高的ppMG对接受MV-TEER的DMR患者临床事件的影响.
- 评估1年的临床结果与不同程度的术后平均梯度的关系.
主要方法:
- 从GIOTTO注册表分析了371名DMR患者的队列,这些患者接受了MV-TEER治疗.
- 患者根据他们的术后平均梯度 (ppMG) 被分为三层.
- 主要终点是所有死因和心力衰竭住院治疗在1年随访后的综合结果.
主要成果:
- 在ppMG>4 mmHg或≥5 mmHg和不良临床事件之间没有发现独立的关联.
- 在最高的ppMG三位数 (p=0.009) 中观察到较高的残留额头回风险 (rMR>2+).
- ppMG> 4 mmHg和rMR ≥ 2+的组合是不良事件的强有力的独立预测因素 (HR: 1.98;95% CI: [1.10-3.58]).
结论:
- 在现实实践中,在DMR的MV-TEER后单独升高的ppMG不能预测1年的不良事件.
- 升高的ppMG和显著的残留 mitrale 反 (rMR) 的同时存在是不良结果的关键预测因素.
- 这一发现凸显了在MV-TEER程序中评估ppMG和rMR的风险分层的重要性.
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