在不同的临床场景中,心声图与侵袭性大动脉梯度对比不同临床场景
Amr E Abbas1, Houman Khalili2, Luai Madanat3
1Corewell Health, William Beaumont University Hospital, Royal Oak, Michigan; Oakland University William Beaumont School of Medicine, Auburn Hills, Michigan.
概括
心声学衍生的平均梯度显示,经过透气管大动脉置换 (TAVR) 和内TAVR (ViV-TAVR) 后的侵入性措施有显著的差异. 这种在ViV-TAVR中特别高的差异表明,这些措施是不可互换的,可能需要侵入性确认.
科学领域:
- 心脏病学 心脏病学
- 医疗成像医学成像
- 生物医学工程 生物医学工程
背景情况:
- 心声图是评估大动脉狭窄 (AS) 和结构变性 (SVD) 的标准.
- 由于与侵袭性措施的不一致性,人们对心声回声学在评估生物假体门后透气管大动脉置换 (TAVR) 和门内门 (ViV-TAVR) 的准确性存在担忧.
研究的目的:
- 为了比较在AS,SVD,TAVR后和ViV-TAVR后的手术内和放出心声和侵入性平均梯度.
- 为了确定与心声学和侵入性梯度测量之间的不一致性相关的因素.
主要方法:
- 一项多中心研究,涉及5027名接受TAVR或ViV-TAVR的患者.
- 测量了同时进行的手术内心声谱和侵入性平均梯度.
- 计算了绝对和百分比差异,并进行了多变量回归分析.
主要成果:
- 在AS (r=0.69) 和SVD (r=0.56) 中,心声学和侵入性梯度之间存在强烈的相关性.
- 在TAVR后 (r=0.18) 和在ViV-TAVR后 (r=0.61) 观察到微弱的相关性和显著的差异.
- 与AS/SVD (1.3-4%) 相比,TAVR/ViV-TAVR后的百分比差异 (66.7-100%) 显著更高.
结论:
- 心声图和侵入性平均梯度在TAVR/ViV-TAVR后是不可互换的.
- 在TAVR/ViV-TAVR后的高回声心脏图谱梯度需要侵袭性确认.
- 门类型影响梯度测量,气球可扩展门显示出更高的回声心脏学但更低的侵入性梯度.
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