高风险的肺高血压不会使心脏移植的结果变得更糟
Wojciech Rzechorzek1, Subo Dey2, Avisha Shah2
1Departments of Cardiology, New York Medical College/Westchester Medical Center, Valhalla, New York.
The American journal of cardiology
|August 25, 2023
概括
对于患有和没有肺高血压 (PH) 的患者,心脏移植的结果是相似的. 护理方面的进步改善了接受心脏移植的PH患者的存活率,尽管他们的相对数量有所下降.
科学领域:
- 心脏病学 心脏病学
- 胸部外科手术 胸部外科手术
- 移植医学 移植医学
背景情况:
- 肺高血压 (PH) 已被认为是心脏移植 (HT) 的禁忌,因为与此相关的死亡率增加.
- 最近医疗保健的进步可能改善了当代PH的HT接受者在现代的治疗结果.
研究的目的:
- 评估高风险肺高血压对心脏移植后生存和发病率的影响.
- 分析高风险肺高血压患者心脏移植的国家趋势.
主要方法:
- 追溯分析98个心脏移植接受者在一个机构 (2014-2018),分层由高风险的PH.
- 国家趋势分析 (1994-2018) 来自联合器官共享网络的单器官HT接受者高风险PH的登记.
- 群体之间的生存率,发病率和血液动力学变化的比较.
主要成果:
- 在机构层面,没有PH的患者的3年生存率为87%,PH患者的81% (p=0.96).
- 2018年全国数据显示,类似的3年生存率:没有PH的86%和PH的87% (p=0.84).
- 肺血管阻力和肺间梯度在两组中都在HT后得到改善. 患有PH的HT接受者的比例从25% (1994) 降至19% (2018).
结论:
- 高风险的肺高血压与类似的早期和晚期死亡率有关,与心脏移植接受者没有PH相比.
- 肺高血压在心脏移植后立即改善.
- 国家数据表明,随着时间的推移,HP的HT患者的生存率有所改善,尽管此类接受者的比例正在下降.
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