中心梯度的变化与接受过导管边缘到边缘修复的患者的结果有关
Roni Sraya1, Itshak Amsalem2, Shemy Carasso2
1Jesselson Integrated Heart Center, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University, Jerusalem, Israel; Department of Military Medicine, Hebrew University of Jerusalem, Tzameret Program, Israel.
International journal of cardiology
|January 11, 2024
概括
通过导管边缘到边缘修复 (TEER) 进行 mitra regurgitation (MR) 可以增加 mitra 梯度 (MVG). 在MVG手术后更高的变化与一年内心力衰竭住院病例的增加有关.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 心脏外科手术 心脏外科手术
背景情况:
- 过导管边缘到边缘修复 (TEER) 是高风险患者重度额头吐 (MR) 的关键治疗方法.
- 在TEER之后,手术后额头梯度 (MVG) 的增加可能会对患者的结果产生负面影响,包括死亡率和住院治疗.
研究的目的:
- 在TEER之后评估绝对的手术后MVG.
- 为了比较绝对MVG和MVG变化 (delta MVG) 对患者结局的影响,特别是死亡率和心力衰竭住院治疗 (HFH).
主要方法:
- 分析了100名接受TEER治疗严重MR的患者队列.
- 患者根据绝对的术后MVG和MVG的变化 (术前到术后) 进行了分层.
- 主要终点是所有原因的死亡率和TEER后一年的HFH.
主要成果:
- 平均MVG从手术后立即增加到第二天 (3.39 mmHg到4.83 mmHg).
- 通过绝对的手术后MVG (>5 mmHg vs. ≤5 mmHg) 的分层显示,生存率或HFH率没有显著差异.
- 根据三角形MVG (≥3 mmHg vs. <3 mmHg) 的分层显示,≥3 mmHg的三角形MVG与明显更高的高血压率 (35.6% vs. 12.7%,p=0.014) 相关.
结论:
- 与手术后立即相比,中枢梯度通常在TEER后的第二天增加.
- 在TEER之后,MVG (delta MVG ≥3 mmHg) 的较大增加是心力衰竭在一年内增加住院治疗的显著预测因素.
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