下肢内血管治疗后减少左心室射出小部分的预后影响
Keiko Fukino1, Daisuke Ueshima2, Tetsuo Yamaguchi3
1The Third Department of Internal Medicine, Teikyo University Chiba Medical Center.
概括
低左心室射出分数 (LVEF) 独立预测在接受内血管治疗 (EVT) 的下肢动脉疾病 (LEAD) 患者的不良结果. 管理心脏功能障碍是改善EVT后预后的关键.
科学领域:
- 心血管医学 心血管医学
- 血管外科 血管外科
- 干预心脏病学 干预心脏病学
背景情况:
- 在接受内血管治疗 (EVT) 的下肢动脉疾病 (LEAD) 患者心力衰竭的预后影响仍然不清楚.
- 左心室喷射率 (LVEF) 是心脏功能的一个关键指标.
- 这项研究调查了LVEF对LEAD患者治疗EVT的结果的影响.
研究的目的:
- 确定左心室射出分数 (LVEF) 的预后意义在接受内血管治疗 (EVT) 的下肢动脉疾病 (LEAD) 患者中.
- 评估低LVEF是否可以独立预测主要的心血管和脑血管不良事件 (MACCEs) 和主要的不良肢体事件 (MALEs).
主要方法:
- 分析了2014年8月至2016年8月期间接受EVT的2,180名LEAD患者的队列.
- 患者被分为低LVEF (LVEF<40%) 和不低LVEF组.
- 使用多变量分析确定了MACCE和MALE的独立预测因子.
主要成果:
- 低LVEF组患心力衰竭,糖尿病,慢性病和关键四肢缺血的患病率更高.
- 低的LVEF独立地与MACCE (HR:2.23) 和MALE (HR:1.85) 的发病率增加有关.
- 低LVEF与不良事件之间的关联是一致的,无论症状性心力衰竭状态如何.
结论:
- 低左心室喷射分数 (LVEF),而不是仅仅是症状性心力衰竭,在EVT后的LEAD患者中显著增加了MACCE和MALE的风险.
- 优化心脏功能障碍管理可能对改善LEAD患者接受EVT的预后至关重要.
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