超导管大动脉置换预测与增强的平均动脉压力
Chieh-Ju Chao1,2, Pradyumna Agasthi1,2, Amith R Seri1
1Department of Cardiovascular Diseases, Mayo Clinic Arizona, Scottsdale, AZ 85259, USA.
Journal of cardiovascular development and disease
|May 26, 2023
概括
新增强的平均动脉压 (AugMAP) 参数有效预测过导管大动脉置换 (TAVR) 后的死亡率. AugMAP提供了一种简单而强大的工具,用于识别高风险患者并改善TAVR结果.
科学领域:
- 心脏病学 心脏病学
- 医疗成像医学成像
- 生物医学工程 生物医学工程
背景情况:
- 评估通过导管大动脉置换 (TAVR) 后患者的结果至关重要.
- 通过使用血压和大动脉梯度,开发了新的心声学参数,增强缩血压 (AugSBP) 和增强平均动脉压 (AugMAP).
研究的目的:
- 评估AugSBP和AugMAP在预测TAVR后死亡率方面的有效性.
- 将这些新参数的预测性能与胸部外科医生协会 (STS) 风险评分进行比较.
主要方法:
- 利用了梅奥诊所国家心血管疾病注册-TAVR数据库 (2012-2017) 的数据.
- 分析了974名患者,使用考克斯回归评估了AugSBP,AugMAP和门动脉阻抗 (Zva).
- 雇佣受理者运营特征 (ROC) 曲线分析和c指数,以将模型性能与STS风险评分进行比较.
主要成果:
- 确定了AugSBP和AugMAP作为中期TAVR后死亡率的独立预测因素 (p < 0.0001).
- AugMAP1 < 102.5 mmHg显著增加了一年全因死亡风险 (HR 3.0,p < 0.0001).
- 在AugMAP1模型中,STS风险评分的预测准确度高于STS风险评分 (AUC:0.700比0.587,p=0.005;c指数:0.681比0.585,p=0.001).
结论:
- 增高平均动脉压 (AugMAP) 是一种简单但有效的工具,用于TAVR后患者的风险分层.
- 这个参数可以帮助临床医生识别有风险的个体,有可能改善TAVR后患者的预后.
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