在TAVR期间肺堵塞的轨迹
Teruhiko Imamura1, Toshihide Izumida2, Hiroshi Onoda2
1The Second Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan. teimamu@med.u-toyama.ac.jp.
Cardiovascular intervention and therapeutics
|December 1, 2023
概括
通过远程介电传感 (ReDS) 测量的肺液体体积在经过过导管大动脉置换 (TAVR) 的40%患者中没有减少. 这种缺乏流体减少预测TAVR后的死亡率和再接收率更高.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 肺部医学 肺部医学
背景情况:
- 严重的大动脉狭窄会导致由于增加后负载而导致肺堵塞.
- 超导管大动脉置换 (TAVR) 是一种常见的治疗方法,但手术后的流体状况需要进一步调查.
- 远程介电传感 (ReDS) 提供了非侵入性的肺液量化.
研究的目的:
- 在TAVR期间和之后使用ReDS评估肺液体体积的轨迹.
- 评估TAVR后持续性肺堵塞的预后影响.
主要方法:
- 研究了一组57名患有严重大动脉狭窄的患者,接受TAVR治疗.
- 在入院和出院时进行了ReDS测量.
- 对患者进行了随访,以确定死亡率和所有原因的再入院.
主要成果:
- 用ReDS值表示的肺液体体积,从入院到出院没有显著变化 (中位数为27%至26%,p=0.65).
- 40%的患者 (23/57) 没有经历ReDS值的下降.
- 缺乏ReDS降低与死亡或再入院风险增加有关 (aHR3.40,p=0.048),特别是在冠状动脉疾病和心房动的患者中.
结论:
- 在TAVR患者中,很大一部分患者表现出持续的肺堵塞.
- 在TAVR后肺液不减少是不良结果的预测指标.
- 需要进一步的研究来开发治疗策略,以管理TAVR后的残留肺堵塞.
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