右心室后负荷的预后价值在接受中枢管过导管边缘到边缘修复的患者中
Rody G Bou Chaaya1, Taha Hatab1, Sahar Samimi1
1Houston Methodist DeBakey Heart and Vascular Center Houston TX.
Journal of the American Heart Association
|April 3, 2024
概括
肺高血压和二次 mitra 吐预测过导管边缘到边缘修复后的结果不好. 评估右心室后负荷 (Ea) 程序前改善了患者对此干预的选择.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 肺高血压研究 肺高血压研究
背景情况:
- 肺高血压 (PH) 和二次腹 (MR) 与转管管边缘到边缘修复 (TEER) 后不良结果有关.
- 侵袭性测量右心室后负荷 (肺有效动脉弹性,Ea) 可能在接受TEER的患者中提供预后价值.
研究的目的:
- 在接受TEER的患者中评估侵袭性测量右心室后负荷的预后意义.
- 根据PH严重程度和MR病因学对患者进行分层,以预测TEER后的结果.
主要方法:
- 在TEER后一个月内接受右心导管治疗的患者的回顾性分析.
- 通过肺有效动脉弹性 (Ea) 值和MR病原发生 (初级与二级) 分层的患者.
- 考克斯回归分析用于检查患者个人资料与2年全因死亡率或死亡率/心力衰竭住院治疗之间的关联.
主要成果:
- 较高的Ea (≥0.6) 与共发病率和二次MR的增加有关.
- 与低弹性 (85.5%对50.4%对41.0%,P=0.001) 相比,患有较高Ea (HE-和HE+) 的患者的两年无事件存活率明显较低.
- 主要MR患者的弹性较低的结果比具有更高弹性或二次MR (85.5%对55.5%对46.1%,P=0.005) 的结果更好.
结论:
- 对心肺状况的程序前评估,包括mPAP,MR病因和Ea,对于指导患者选择TEER至关重要.
- 血液动力学分析识别患者可能受益或不太可能受益于TEER在PH或二次MR的背景下.
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