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通过导管进行大动脉置换的患者心肝综合征
Lukas Stolz1, Michael Kirchner1, Julius Steffen1
1Medizinische Klinik und Poliklinik I, Klinikum der Universität München, Marchioninistr. 15, 81377, Munich, Germany.
概括
心肝综合征 (CHS),在22%的TAVR患者中流行,显著预测了更差的三年生存率. 识别CHS对于TAVR决策和改善患者治疗结果至关重要.
科学领域:
- 心脏病学 心脏病学
- 肝病学 肝病学是一种肝病学.
- 通过导管进行大动脉替换 (TAVR)
背景情况:
- 心肝综合征 (CHS) 是心血管疾病生存的未被认可的预测因素.
- 它的患病率和预后影响在TAVR中对严重的大动脉狭窄症 (AS) 需要评估.
研究的目的:
- 评估在接受TAVR治疗严重AS的患者中CHS的患病率.
- 确定CHS在TAVR后的生存,技术结果和功能状态方面的预后价值.
主要方法:
- 分析了一组953名接受TAVR的患者,具有可用的肝功能参数.
- CHS是由升高的胆红素,性酸酶或玛-氨基转移酶定义的.
- 结果包括3年生存期,VARC-3定义的技术/设备故障,以及NYHA功能类.
主要成果:
- 在22.4%的患者中存在CHS (n=212).
- 技术和设备故障率在CHS和非CHS组之间是相似的.
- 患有CHS的患者具有更严重的NYHA类和显著较低的3年生存率 (49.4%vs65.4%,p<0.001).
- CHS仍然是死亡率的独立预测因素 (HR 1.58,p<0.01).
结论:
- 在22%的TAVR患者中,CHS是严重AS的流行病.
- CHS与更糟糕的3年生存率和更严重的心力衰竭症状有关.
- 建议将CHS评估纳入TAVR心脏团队的决策.
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