在二次MR患者中,复发体积与LA体积的比率:COAPT试验
Augustin Coisne1,2,3, Andrea Scotti1,2, Juan F Granada1
1Clinical Trials Center, Cardiovascular Research Foundation, New York, NY, USA.
European heart journal. Cardiovascular Imaging
|December 7, 2023
概括
对左心房体积 (RVol/LAV) 的 mitra 排泄严重程度低的比率预测了二次MR患者的心力衰竭住院的情况.无论这种比率如何,过导管边缘到边缘修复 (TEER) 改善了结果.
科学领域:
- 心脏病学 心脏病学
- 心血管医学 心血管医学
- 医疗器械 医疗器械
背景情况:
- 对比例与不相称的额头肌吐 (MR) 的标准评估对于患有二次MR的个体心力衰竭 (HF) 患者来说是不充分的.
- 一个新的指数,即吐体积与左心房体积比率 (RVol/LAV),可以识别患有不成比例的MR和高事件风险的患者.
研究的目的:
- 评估RVol/LAV比率在HF患者中具有严重的二次MR的预后意义.
- 为了评估在COAPT试验中随机分配到跨导管边缘到边缘修复 (TEER) 加准则导向医疗疗 (GDMT) 和单独GDMT的患者的结果.
主要方法:
- 在567名COAPT试验患者的基线心声谱中计算了手术前RVol/LAV.
- 评估了2年HF住院率 (HFH) 的初级终点.
- 分析了RVol/LAV与HFH,死亡率,健康状况和功能能力的关联.
主要成果:
- 较低的RVol/LAV独立地与仅GDMT组的2年HFH风险增加有关 (adjHR: 1.77).
- RVol/LAV被证明是一种比单独的RVol或LAV更强的不良结果预测器.
- 与单独使用GDMT相比,TEER加GDMT可降低2年HFH率,而不论基线RVol/LAV.
结论:
- 较低的RVol/LAV比率独立地预测GDMT单独治疗的重度二次MR患者的2年HFH.
- 在重度二次性MR患者中,TEER显示改善了临床结果,独立于基线RVol/LAV比率.
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