同时发生的功能性心肌吐对严重大动脉狭窄患者的存活率的重要性,这些患者接受了大动脉置换术
Ramdas G Pai1, Padmini Varadarajan2
1Department of Cardiology, University of California Riverside School of Medicine, Riverside/St. Bernardine Medical Center, San Bernardino, Riverside, CA 92521, United States. ramdaspai@yahoo.com.
World journal of cardiology
|June 5, 2023
概括
在接受大动脉置换 (AVR) 的严重大动脉狭窄症 (AS) 患者中,腹吐 (MR) 与更差的存活率有关. 超过2+MR独立预测减少的存活率,无论喷射分数或症状.
科学领域:
- 心血管医学 心血管医学
- 心脏外科手术 心脏外科手术
- 临床结果研究研究
背景情况:
- 在接受主动脉置换 (AVR) 的患者中,腹 (MR) 经常与严重主动脉缩 (AS) 并存.
- 在严重的AS患者中,并发性MR的长期预后影响尚未得到充分证实.
研究的目的:
- 评估腹 (MR) 对严重大动脉狭窄 (AS) 患者的长期存活的独立影响,这些患者接受了手术大动脉置换 (AVR).
- 确定MR严重程度是否影响该患者群体的死亡风险.
主要方法:
- 在1993年至2003年期间接受AVR的287名严重AS患者的队列被追溯分析.
- 对患者进行了长达26年的随访,收集了临床状态,心声和治疗数据.
- 副回被分级 (1-4级),并使用Cox回归来分析MR严重程度的生存率.
主要成果:
- 总体而言,5年,10年和20年的生存率分别为75%,45%和25%.
- MR 的存在和严重程度与死亡率的增加显著相关 (P = 0.0003).
- 独立预测MR的死亡率更高,即使考虑到左心室喷射率 (EF) 减少和LV末缩维度更大.
结论:
- 在接受外科AVR手术的严重AS患者中,超过2+MR是减少长期存活的独立预测因素.
- MR 对生存的不良影响与减少EF和增加LV大小的影响相比是渐进式的.
- 建议考虑在重症AS患者中进行大动脉干预>2+MR,无论EF或症状如何.
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