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在严重大动脉狭窄症的干预后,患者报告的症状的演变和预后意义

J Alberto San Román¹, Cristina Ybarra-Falcón², Mario García-Gómez²

¹Cardiology Department, Hospital Clínico Universitario, Valladolid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain.

Mayo Clinic proceedings

|March 3, 2024

概括

许多患有严重的大动脉狭窄症的患者在门置换后会出现持续的症状,特别是呼吸不全和昏迷. 这种症状的持续性与较高的死亡风险有关,这突显了需要仔细的患者管理的需要.

科学领域:

心脏病学心脏病学
心脏外科手术心脏外科手术
膜心脏疾病膜心脏疾病

背景情况:

症状严重的大动脉狭窄症 (sSAS) 显著影响生活质量.
对于sSAS的门置换后的症状的长期演变及其预后影响仍然不完全理解.

研究的目的:

为了研究患者的症状演变,sSAS后门置换.
为了确定症状持续性的预测因素.
为了确定持续症状的预后意义.

主要方法:

对451名接受门置换的sSAS患者的回顾性分析.
在干预前后评估症状状态 (呼吸不全,心痛,昏迷,心力衰竭).
随访所有原因和心血管死亡率.

主要成果:

超过一半的患者 (57.4%) 经历了持续的症状,最常见的是呼吸障碍和休息时昏迷.
症状持续的预测因素包括年龄,BMI,先前的心力衰竭入院和COPD.
在56个月的中位随访期间,症状的持续性独立地与所有原因死亡率的增加有关.

结论:

很大一部分患有sSAS的患者在门置换后继续出现症状.
持续的症状,特别是休息时的昏迷,是预后不佳的标志.
对管理残留症状的进一步研究是有必要的.

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