过导管大动脉植入后急性皮质类固醇对导电缺陷的影响:CORTAVI研究
Lucy Barone1, Saverio Muscoli1, Martina Belli2,3
1Division of Cardiology, Department of Medical Science, Fondazione Policlinico Tor Vergata.
Journal of cardiovascular medicine (Hagerstown, Md.)
|July 6, 2023
概括
皮质类固醇并没有显著降低穿透导管大动脉植入 (TAVI) 后的永久起器 (PPM) 植入. 这项研究发现,TAVI后,口服普雷尼松对导电缺陷没有保护作用.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 药理学 药理学是指药理学的学科.
背景情况:
- 导电异常在跨导管大动脉植入 (TAVI) 后很常见,通常需要永久起器 (PPM) 植入.
- 这些导电缺陷的潜在机制,可能涉及炎症和,尚未完全理解.
- 皮质类固醇具有抗炎和抗性质,这表明它可能在缓解TAVI后电脑并发症方面发挥作用.
研究的目的:
- 调查皮质类固醇在TAVI后预防导电缺陷方面的潜在保护作用.
- 评估口服普雷尼松是否影响心房阻塞 (AVB) 的发生率或TAVI后需要PPM植入的需要.
主要方法:
- 一个回顾性单中心研究,涉及96名接受TAVI治疗的患者.
- 32名患者在手术后接受了口服普得尼松 (50毫克5天),形成了治疗组.
- 与对照组 (未接触过普得尼松) 进行比较,随访期为2年.
主要成果:
- 在住院期间,在普得尼松组 (12%) 和对照组 (17%) 之间,新PPM植入的总体频率没有显著差异.
- 心室膜阻塞,右束分支阻塞和左束分支阻塞的发生率在两组之间没有显著差异.
- 在2年的随访中,这两组患者中没有患者需要PPM植入,也没有记录过严重的心律失常.
结论:
- 口服普雷迪尼松治疗没有显著减少TAVI后需要急性PPM植入的心房阻塞的发生率.
- 这些发现表明,在TAVI手术后,皮质类固醇可能无法有效预防导电缺陷.
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