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大动脉狭窄症在双和三大动脉门的进展的决定因素
Mylène Shen1, Lionel Tastet1, Romain Capoulade2
1Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Université Laval, Québec City, Québec, Canada.
CJC pediatric and congenital heart disease
|November 16, 2023
概括
影响大动脉狭窄进展的因素在双大动脉 (BAV) 和三大动脉 (TAV) 患者之间有所不同. 肥胖,糖尿病和尖端融合驱动BAV的进展,而慢性脏病影响TAV的进展.
科学领域:
- 心脏病学 心脏病学
- 膜心脏疾病 膜心脏疾病
- 大动脉狭窄症 大动脉狭窄症
背景情况:
- 双主动脉 (BAV) 与加速的主动脉狭窄症 (AS) 的进展有关.
- 在BAV与三主动脉 (TAV) 患者中,AS进展的决定因素仍然不清楚.
研究的目的:
- 确定与BAV.患者AS进展相关的因素.
- 将这些因素与TAV患者的因素进行比较.
主要方法:
- 预期招募AS患者参加PROGRESSA研究 (NCT01679431).
- 使用年化峰值大动脉喷流速度 (Vpeak) 评估AS的血液动力学进展.
- 单变量和多变量线性回归分析以确定进展因子.
主要成果:
- 在BAV患者 (n=79),肥胖 (β=0.25,P=0.04),糖尿病 (β=0.26,P=0.02) 和右非冠状动脉尖端融合 (β=0.29,P=0.01) 独立地与更快的AS进展有关.
- 在TAV患者 (n=208) 中,基线AS严重程度 (V峰值,β=0.14,P=0.04) 和慢性病 (β=0.16,P=0.02) 与AS进展有显著的关联.
- 基线AS严重程度和进展率在BAV和TAV组之间是相似的.
结论:
- 驱动AS进展的因素在BAV和TAV之间存在显著差异.
- 肥胖,糖尿病和右非冠状动脉尖端融合是BAV进展的关键因素.
- 慢性病是TAV进展的一个重要因素.
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