在设备关闭后,左心房附属体的预后影响
Mu Chen1, Peng-Cheng Yao1, Zhen-Tao Fei1
1Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, China.
Circulation. Cardiovascular interventions
|April 17, 2024
概括
在WATCHMAN设备关闭后,左心房附属体 (LAA) 的通透性增加了心房动患者中风风险. 即使是小的泄漏也会影响预后,强调需要仔细监测和管理.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 干预程序 干预程序
背景情况:
- 在心房 (AF) 患者中,左心房附属体 (LAA) 关闭后LAA通透性的预后影响尚未完全理解.
- 可见周围设备泄漏 (PDL) 是一个已知的并发症,但它与LAA通透性的重要性需要进一步调查.
研究的目的:
- 在AF患者植入WATCHMAN 2.5设备后,评估LAA通透率的预后意义,有或没有PDL.
- 为了确定与LAA通透性患者的不良事件相关的危险因素.
主要方法:
- 预计将招募519名接受WATCHMAN 2.5设备的AF患者.
- 3个月的心脏计算机断层扫描血管学 (CCTA) 用于LAA监测.
- 完全关闭和LAA通透性组之间的不良事件 (中风/TIA,出血,死亡,MAE) 的比较.
主要成果:
- 在47.8%的患者中观察到LAA通透率 (37.8%有PDL,10.0%没有).
- 通过LAA显著增加了中风/TIA (aHR 3.22) 和MAE (aHR 1.12) 的风险.
- 增加的PDL大小与中风/TIA,心血管死亡和MAE的更高发病率相关.
结论:
- 关闭后3个月,CCTA检测到的LAA通透率与使用WATCHMAN设备的AF患者的治疗结果较差有关.
- 可见的PDL,无论大小如何,都与中风/TIA和MAE风险增加有关.
- 老年和停止抗血小板治疗预测LAA通透性患者的不良事件.
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