阻塞性多变性心肌病症中中枢环状化:肌肉切除术后的发病率,风险因素和预后值
Zining Wu1, Changrong Nie1, Changsheng Zhu1
1Department of Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
International journal of cardiology
|August 13, 2023
概括
在接受心肌切除术的高度阻塞性心肌病 (OHCM) 患者中,心肌环形化 (MAC) 预测了更糟糕的结果,包括更高的死亡率和复发性心肌回. 中度至重度的MAC独立增加了手术后主要心血管不良事件的风险.
科学领域:
- 心脏病学 心脏病学
- 医疗成像医学成像
- 心血管外科心血管外科
背景情况:
- 中心环状化 (MAC) 是已知的心脏手术风险因素.
- 有限的数据存在于CT诊断的MAC的预后价值在肌肉切除术后的高压阻塞性心肌病 (OHCM) 患者.
- 调查MAC对门功能和OHCM手术后患者结果的影响至关重要.
研究的目的:
- 为了评估手术前计算机断层扫描 (CT) 诊断的脑膜环状化 (MAC) 的预后意义,在为高压阻塞性心肌病 (OHCM) 接受隔膜切除术的患者中.
- 评估MAC对门功能和肌肉切除术后的长期临床结果的影响.
主要方法:
- 对1035名连续接受隔膜肌切除术的OHCM患者的回顾性分析.
- 术前CT扫描用于诊断和评分MAC.
- 使用卡普兰-梅尔分析,日志级别测试和考克斯回归来比较生存率并评估MAC对终点事件的影响.
主要成果:
- 在10.8%的OHCM患者中,MAC存在,与女性性别,年龄较大,大动脉化和中枢厚化有关.
- 患有MAC的患者表现出较高的全因死亡率,主要的不良心血管和脑血管事件 (MACCE),复发的额头骨吐,以及肌肉切除术后的NYHA类III-IV症状.
- 中度至重度的MAC是长期MACCE (HR 2.03) 的独立预测因素,MAC独立预测了复发的额头肌吐 (HR 2.47).
结论:
- 在手术前CT诊断的MAC在OHCM患者中很普遍,并且与衰老和动脉样硬化有关.
- 患有MAC的OHCM患者表现出较差的预后,包括增加MACCE和复发的甲骨管吐,与没有MAC的患者相比,在隔膜肌切除术后.
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