经过过导管心肌边缘到边缘修复后,左心室功能急性减少
Leor Perl1, Mark Kheifets1, Ascione Guido2
1Division of Cardiology, Rabin Medical Center-Beilinson Hospital, Petah-Tikva, Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel.
Journal of the American Heart Association
|June 22, 2023
概括
过导管 mitra 的修复可以减少左心室喷射率 (LVEF),特别是在初级 mitra 吐 (PMR). 这种LVEF降低与PMR患者的治疗结果较差有关,但与二次额叶吐 (SMR) 患者无关.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 心脏外科手术 心脏外科手术
背景情况:
- 过导管 mitra 边缘到边缘修复 (TEER) 是对 mitra 吐的常见治疗方法.
- TEER对左心室喷射率 (LVEF) 和随后的预后的影响尚不清楚.
- 在TEER之后,LVEF的急性降低可能会影响患者的治疗结果.
研究的目的:
- 评估对初级心肌吐 (PMR) 和二次心肌吐 (SMR) 的TEER后的LVEF变化.
- 为了确定TEER后急性LVEF降低 (LVEFR) 的预测因素和率.
- 评估LVEFR对死亡率和主要心脏不良事件的预后影响.
主要方法:
- 一个国际多中心注册表包括了为PMR或SMR接受TEER的患者.
- 急性LVEF降低 (LVEFR) 被定义为LVEF相对降低>15%.
- 评估结果包括全因死亡率,主要心脏不良事件和12个月后的LVEF.
主要成果:
- 在2534名患者中,18.5%患有LVEFR.
- 在PMR患者中,LVEF在12个月内显著下降,但不是SMR患者.
- 与没有 (9.7%) 患者相比,患有LVEFR的PMR患者的1年死亡率更高 (16.9%).
结论:
- 减少LVEF是TEER后的一个显著并发症,特别是在PMR中.
- 在PMR患者中,LVEFR与更糟糕的预后有关.
- 在SMR患者中,TEER似乎不会对与LVEF变化相关的预后产生负面影响.
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