严重的大动脉狭窄:发生率和结果的长期趋势
Giovanni Benfari1,2, Benjamin Essayagh1,3, Hector I Michelena1
1Department ofCardiovascular Disease, Mayo Clinic, Rochester, MN, USA.
European heart journal
|January 8, 2024
概括
严重的大动脉狭窄 (AS) 发病率在20年内保持稳定,但绝对病例数量由于人口增长而增加. 尽管动脉置换 (AVR) 的使用情况有所改善,但治疗不足和死亡率仍然很高.
科学领域:
- 心脏病学 心脏病学
- 流行病学 流行病学
- 公共卫生 公共卫生
背景情况:
- 严重的大动脉狭窄 (AS) 是大动脉置换 (AVR) 的首要指示.
- 过导管AVR增加了,这表明AS发病率上升,但趋势尚不清楚.
- 关于AS发病率趋势的定量多普勒回声心脏学数据有限.
研究的目的:
- 确定严重AS的发病率,表现,治疗和结果的长期趋势.
- 评估人口增长对严重AS绝对负担的影响.
- 评估大动脉置换 (AVR) 使用率的变化及其对生存的影响.
主要方法:
- 基于人口的研究在奥姆斯特德县,明尼苏达州,从1997年至2016年.
- 通过使用定量多普勒回声心脏学标准,确定了严重的AS病例.
- 分析了20年来发生率,临床特征,AVR率和死亡率的趋势.
主要成果:
- 严重AS发病率稳定在每10万人/年53人左右,但绝对病例由于人口增长而增加.
- 女性的发病率下降,但男性的发病率保持稳定.
- 使用AVR增加并变得更加迅速,与生存益处相关,但治疗不足超过40%,死亡率仍然很高.
结论:
- 严重AS发病率稳定,但人口增长增加了整体病例负担.
- 增加AVR的使用并没有降低与AS相关的死亡率,这突显了持续的治疗不足.
- 调查结果强调需要改进AS管理策略和早期干预.
更多相关视频
相关概念视频
Mitral Stenosis III: Medical Management
481
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...
481
Aortic Regurgitation I: Introduction
1.3K
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...
1.3K
Aortic Regurgitation II: Clinical Features and Diagnostic Tests
966
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...
966
Aortic Regurgitation III: Medical Management
559
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...
559
Aneurysm II: Clinical Manifestations and Diagnostic Studies
544
Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
544
Aneurysm III: Interprofessional Care
458
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
458


