在为主导性大动脉狭窄和混合大动脉病而进行过导管大动脉置换后,左心室逆向整形
Liangyan Huang1, Xiaoyue Lai1, Lei Xu1
1Department of Ultrasound, Second Affiliated Hospital (Xinqiao Hospital), Army Medical University, Chongqing, China.
Journal of clinical ultrasound : JCU
|October 25, 2023
概括
超导管大动脉置换 (TAVR) 对混合大动脉病 (MAVD) 患者有好处,尽管左心室逆向整形受到手术后心肌吐和冠状动脉疾病的影响.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 心脏外科手术 心脏外科手术
背景情况:
- 与主导性大动脉狭窄症 (PAS) 相比,混合大动脉病 (MAVD) 呈现出独特的心脏变化.
- 之前关于TAVR后MAVD结果的研究是矛盾的,需要进一步调查.
- 要了解TAVR在MAVD中的价值,需要评估左心室重塑模式.
研究的目的:
- 为了比较TAVR后的左心室逆转型改造 (LVRR) 在MAVD患者和PAS患者中.
- 在接受TAVR的MAVD患者中确定LVRR不发生的独立风险因素.
主要方法:
- 一项回顾性研究包括90名MAVD和72名接受TAVR的PAS患者 (2018年1月至2021年12月).
- 使用倾向性得分匹配 (1:1) 来确保可比的基线特征.
- 一般化的估计方程和逻辑回归分析了非LVRR的动态变化和风险因素.
主要成果:
- 在匹配后,分析了56名MAVD和56名PAS患者.
- 在这两组中都出现了LVRR,但MAVD患者的左心室终端透支体积指数和质量指数较大.
- 手术后的额叶吐 (MR) 和冠状动脉疾病是非LVRR的独立风险因素.
结论:
- 左心室逆转型改造 (LVRR) 在TAVR之后可以在MAVD患者中实现.
- 手术后的额叶吐 (MR) 显著增加了非LVRR的风险.
- 在这个队列中,冠状动脉疾病也被确定为非LVRR的独立风险因素.
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