未经治疗的大动脉狭窄症的死亡率负担
Philippe Généreux1, Rahul P Sharma2, Robert J Cubeddu3
1Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, New Jersey, USA.
Journal of the American College of Cardiology
|October 25, 2023
概括
死亡风险随着大动脉狭窄 (AS) 的严重程度而增加,即使在未经治疗的情况下也是如此. 对于严重的AS,大动脉置换率很低,这表明需要进一步研究诊断和治疗障碍.
科学领域:
- 心脏病学 心脏病学
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
- 公共卫生 公共卫生
背景情况:
- 目前的指导方针建议在严重的大动脉狭窄 (AS) 时根据心声图评估进行大动脉置换 (AVR).
- 然而,关于未经治疗的AS全谱死亡率的现实数据有限.
研究的目的:
- 为了研究不同程度的未经治疗的大动脉狭窄症患者的死亡率.
- 分析不同严重程度上对大动脉狭窄的治疗率.
主要方法:
- 利用了大量的非身份化现实数据集,包括来自美国24家医院的1,085,850名患者的1,669,536份心声回声报告.
- 根据AS严重程度对患者进行分类,并使用Kaplan-Meier估计和多变量危险分析检查未治疗的死亡率和治疗率.
主要成果:
- 没有治疗的四年死亡率随着AS严重程度的增加而增加,从13.5% (没有) 到44.9%-45.7% (严重).
- 所有严重症的AS治疗率都很低,即使在严重的病例中,只有60.7%的患者接受AVR治疗.
- 所有AS严重程度都与调整后所有原因死亡率的增加有关.
结论:
- 患有大动脉狭窄症的患者面临高死亡风险,无论严重程度如何,如果不治疗,就会死亡.
- 由于严重的AS患者的大动脉置换率低,需要解决诊断和治疗障碍.
更多相关视频
06:51Author Spotlight: Development of a Minimally Invasive Large-Animal Model for Reliable and Reproducible Cardiovascular Research
Published on: October 20, 2023
1.1K
14:14Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
14.1K
相关概念视频
01:15Aortic Regurgitation I: Introduction
10
IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
10
01:26Mitral Stenosis III: Medical Management
12
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
12
01:22Mitral Stenosis I: Introduction
15
Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
15
01:25Aortic Regurgitation III: Medical Management
24
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
24
01:22Aortic Regurgitation II: Clinical Features and Diagnostic Tests
22
Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
22
01:23Mitral Stenosis II: Clinical features and Diagnostic Tests
22
Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
22