患有不一致的高梯度大动脉狭窄症患者的患病率和结果
Philippe Unger1, Andréanne Powers2, Emma Le Nezet2
1Cardiology Department, CHU Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium.
Journal of the American College of Cardiology
|March 20, 2024
概括
不一致的高梯度大动脉狭窄症 (DHG-AS) 是常见的,预后不好,类似于严重的大动脉狭窄症. 高压梯度表明更糟糕的结果,无论大动脉膜区域或反的严重程度.
科学领域:
- 心脏病学 心脏病学
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
- 膜心脏疾病 膜心脏疾病
背景情况:
- 对于不一致的高梯度大动脉狭窄症 (DHG-AS) 存在相互矛盾的预后数据.
- 之前的研究排除了患有大动脉反的患者.
- DHG-AS被定义为平均压力梯度≥40mmHg和大动脉面积 (AVA) >1cm2.
研究的目的:
- 为了确定DHG-AS的流行率和生存率.
- 为了分析连续患者的未经选择的队列.
- 在第三级推中心的心声回声实验室评估DHG-AS.
主要方法:
- 对3547名成年患者 (2005-2015年) 的回顾性分析.
- 纳入标准:AVA ≤1.5 cm2,峰值速度≥2.5 m/s或平均梯度≥25 mm Hg.
- 收集的临床数据,心声学数据和大动脉膜 (AVC) 评分.
主要成果:
- 在11.6%的高梯度病例 (163名患者) 中发现了DHG-AS.
- DHG-AS死亡率类似于严重的大动脉狭窄 (aHR:0.98) 和不协调的低梯度AS (aHR:0.85).
- 死亡率高于中度大动脉狭窄 (aHR:0.54);大动脉吐和AVC没有显著影响生存率.
结论:
- 不一致的高梯度大动脉狭窄症并不罕见.
- 高压梯度,即使AVA>1.0cm2,也表明预后不佳.
- 预后独立于AVA的严重程度和同时发生的大动脉吐.
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