TRI-SCORE和干预的好处在严重三管吐的患者
Julien Dreyfus1, Xavier Galloo2,3, Maurizio Taramasso4
1Department of Cardiology, Centre Cardiologique du Nord, Saint-Denis, France.
European heart journal
|August 25, 2023
概括
对于严重的功能性三回 (TR) 的早期干预可以改善低风险患者的生存率. 手术或透管TR校正有利于低和中等TRI-SCORE患者,但不是高风险患者.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 干预心脏病学 干预心脏病学
背景情况:
- 三回 (TR) 纠正的益处和干预时间尚不清楚.
- 该TRI-SCORE对TR严重程度进行分层,并指导临床管理.
- 严重的孤立功能TR显著影响患者的存活率.
研究的目的:
- 为了比较外科手术或透导管干预后的生存率与严重功能TR的保守管理.
- 评估TR临床阶段对干预结果的影响,通过TRI-SCORE进行评估.
- 根据患者风险分层来确定TR干预的最佳时间.
主要方法:
- 在TRIGISTRY研究中,招募了2413名患有严重孤立功能TR的患者.
- 患者进行了保守的治疗 (1217),接受了隔离的三膜手术 (551),或通过导管修复门 (645).
- 主要终点是2年生存期,根据TRI-SCORE类别 (低,中,高) 进行分析.
主要成果:
- 在所有治疗组中,随着TRI-SCORE的增加,生存率逐渐下降 (P < .0001).
- 在低TRI-SCORE的患者中,手术 (93%) 和透导管 (87%) 的干预比保守治疗 (79%) 显示出更高的生存率.
- 在中期TRI-SCORE患者中,干预效益只有在成功纠正 (81%对71%) 时才显著. 高TRI-SCORE患者从干预中没有生存益处.
结论:
- 三回 (TR) 干预时间和效益受到TRI-SCORE的强烈影响.
- 早期,成功的手术或透管TR校正改善了低和中等TRI-SCORE患者的2年生存率.
- 与保守管理相比,在高TRI-SCORE组的干预措施中没有观察到生存益处.
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