严重的Fontan相关性肝病及其与死亡率的关联
Carlos-Eduardo Guerrero-Chalela1,2,3, Judith Therrien1,2, Yoni Grossman1
1McGill Adult Unit for Congenital Heart Disease Excellence (MAUDE Unit) McGill University Health Centre Montreal Quebec Canada.
Journal of the American Heart Association
|September 30, 2023
概括
严重的Fontan相关肝病 (FALD) 显著增加了Fontan患者的死亡风险. 随着时间的推移,这种风险越来越大,凸显了对Fontan循环的监测和改进的外科手术技术的需要.
科学领域:
- 心脏病学 心脏病学
- 肝病学 肝病学是一种肝病学.
- 儿科手术 儿科手术
背景情况:
- 关于严重的Fontan相关性肝病 (FALD) 发病率和死亡率相关性的数据有限.
- 芬坦手术患者面临着独特的长期肝脏并发症风险.
研究的目的:
- 为了估计Fontan患者的严重FALD发病率与腹腔隔膜缺陷 (VSD) 患者.
- 评估严重的FALD和死亡率之间的关联.
- 为了确定严重FALD发展的风险因素.
主要方法:
- 使用了北克先天性心脏病数据库.
- 包括512名Fontan患者和10,232名VSD患者.
- 他采用了卡普兰-梅尔曲线和考克斯比例危险模型.
主要成果:
- 与VSD患者 (2,75%) 相比,Fontan患者的严重FALD累积风险显著更高 (52.24%到35年).
- 严重的FALD与5年内死亡风险增加3倍以上有关.
- 充血性心力衰竭,心室上高心率和最近的Fontan完成被确定为危险因素.
结论:
- 严重的FALD显著提高了Fontan患者的死亡率.
- FALD风险取决于时间,在Fontan.后35年达到50%以上.
- 损害Fontan血液动力学的条件与严重的FALD发展有关.
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