右心室 - 肺动脉合的演变和预后影响 跨导管大动脉置换后的右心室 - 肺动脉合
Maria Chiara Meucci1, Silvia Malara2, Steele C Butcher3
1Department of Cardiovascular Science, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.
JACC. Cardiovascular interventions
|July 12, 2023
概括
在过导管大动脉置换 (TAVR) 后的右心室肺动脉 (RV-PA) 脱离预测死亡率. 在TAVR后的RV-PA脱,尤其是严重的病例,表明预后更差,有助于风险分层.
科学领域:
- 心脏病学 心脏病学
- 心血管成像 - 心血管成像
- 干预心脏病学 干预心脏病学
背景情况:
- 关于右心室到肺动脉 (RV-PA) 合和转导管后大动脉置换 (TAVR) 后的结果的证据有限.
- 了解RV-PA合动态对于评估TAVR患者预后至关重要.
研究的目的:
- 为了研究TAVR后RV-PA合的变化.
- 为了确定在TAVR之后RV-PA合演变的预后意义.
主要方法:
- 在900名TAVR前后的患者中,心声学被用来测量RV-PA合 (三角形环形平面缩外流/肺动脉缩压力比率).
- 通过特定的TAPSE/PASP值来定义RV-PA脱.
- 全因死亡率作为主要终点.
主要成果:
- 在TAVR后的RV-PA脱观察到45%的患者,并独立预测死亡率增加 (调整HR:1.474).
- 严重的TAVR后RV-PA脱确定了一个高风险子组.
- 实现RV-PA合恢复的患者的结果与正常合患者的结果相似.
结论:
- 在TAVR后的RV-PA脱是长期死亡率的重要独立预测因素.
- 在TAVR后评估RV-PA合反应可以增强患者风险分层.
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