大动脉置换后的心力衰竭:发生率,危险因素和影响
Roopesh Sai Jakulla1, Satya Preetham Gunta2, Chetan P Huded3
1Department of Internal Medicine, University of Missouri-Kansas City, Kansas City, MO 64110, USA.
Journal of clinical medicine
|September 28, 2023
概括
过导管大动脉置换 (TAVR) 改善了严重大动脉狭窄的生存率,但心力衰竭症状仍然存在. 需要新的策略来管理TAVR后心力衰竭并改善患者的治疗结果.
科学领域:
- 心脏病学 心脏病学
- 心血管外科心血管外科
- 心脏衰竭研究研究
背景情况:
- 严重的大动脉狭窄症 (AS) 显著恶化预后,特别是心力衰竭 (HF) 症状,需要大动脉置换 (AVR).
- 过导管大动脉置换 (TAVR) 已经彻底改变了AS管理,使高风险手术候选人的治疗成为可能.
- 尽管生存率有所改善,但TAVR后的残留HF症状和住院是常见的,影响死亡率和健康状况.
研究的目的:
- 审查与大动脉置换 (AVR) 后心力衰竭相关的发病率和风险因素.
- 突出需要改善预防和管理AVR后心力衰竭的策略.
- 探索早期AVR干预的潜在好处,以减轻不良结果.
主要方法:
- 文献综述侧重于研究研究心力衰竭发病率和手术和透导管AVR后的风险因素.
- 对接受AVR的患者心力衰竭的当前管理策略的分析.
- 讨论关于AVR时机及其对长期成果的影响的新兴研究.
主要成果:
- 在AVR,包括TAVR之后,心力衰竭症状和住院仍然很普遍,与死亡率增加相关.
- 已确定的风险因素有助于AVR后HF的发展或持续.
- 在严重症状和额外膜损伤之前的早期AVR干预正在研究改善结果.
结论:
- 对AVR后心力衰竭的有效管理对于提高患者的生存率和生活质量至关重要.
- 进一步研究风险因素修改和AVR最佳时间是有必要的.
- 为接受AVR的AS患者优化护理途径对于解决残留HF挑战至关重要.
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