在患有慢性脏疾病的患者中,透导管大动脉置换对功能和中期结果的影响
Jwan A Naser1, Sushil Allen Luis1, Sorin V Pislaru1
1Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.
The American journal of cardiology
|October 20, 2023
概括
在慢性病 (CKD) 患者中,透导管大动脉置换 (TAVR) 结果表明,晚期CKD预测两年以后的死亡率. 功能往往会在TAVR后得到改善.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 干预心脏病学 干预心脏病学
背景情况:
- 过导管大动脉置换 (TAVR) 是对大动脉狭窄的标准治疗方法.
- 慢性病 (CKD) 患者的长期TAVR结局及其预测因素仍然不清楚.
- 了解这些结果对于优化患者护理至关重要.
研究的目的:
- 评估中期TAVR结果在患有不同阶段的CKD的患者.
- 开发一种风险评分,用于预测接受TAVR的CKD患者的2年死亡率.
- 为了评估TAVR后功能变化.
主要方法:
- 对接受TAVR的成年患者进行了回顾性分析.
- 使用CKD流行病学2021年肌素配方确定CKD病期.
- 通过TAVR后的特定肌素水平变化定义的功能改善.
主要成果:
- 在CKDIV和V阶段观察到较高的全因死亡率,随访时间中位数为2.9年.
- 2年死亡率的独立预测因素包括中度/严重的三腹吐,贫血,右心室缩压升高和晚期CKD (IV/V) 阶段.
- 在出院时,6%的患者经历了持续的急性损伤,而12%的患者显示功能有所改善.
结论:
- 慢性瘤阶段是TAVR后两年死亡率的独立决定因素.
- 一个新的风险评分可以估计TAVR患有CKD的患者2年死亡率.
- 在TAVR后,功能在出院时更有可能改善而不是恶化.
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