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经过过导管大动脉置换后心脏损伤的长期影响
Masaaki Nakase1, Daijiro Tomii2, Dik Heg3
1Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland. Electronic address: https://twitter.com/masaaki0825.
JACC. Cardiovascular interventions
|April 24, 2024
概括
超膜性心脏损伤在跨导管大动脉置换 (TAVR) 之前和之后显著影响长期预后. 在TAVR后心脏损伤阶段的变化对于预测患者的结果和死亡风险至关重要.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 干预心脏病学 干预心脏病学
背景情况:
- 大动脉狭窄可以导致额外膜心脏损伤,影响透气管大动脉置换 (TAVR) 后的预后.
- 缓解机械阻塞对心脏损伤的长期影响需要进一步研究.
研究的目的:
- 为了评估TAVR后心脏损伤的早期变化.
- 为了确定心脏损伤分类在TAVR之后的预后意义.
主要方法:
- 对接受 transfemoral TAVR.患者的回顾性分析.
- 在TAVR之前和之后评估心脏损伤,分为5个阶段 (0-4).
主要成果:
- 在TAVR早期的1863名患者中,47.7%的心脏阶段发生变化 (30.1%的改善,24.7%的恶化).
- 基线和TAVR后的心脏损伤都与5年全因死亡率相关 (调整后的HR分别为1.34和1.40).
- 心脏损伤阶段的变化 (改善,不变,恶化) 将五年死亡率分层分为第二,第三和第四阶段.
结论:
- 在TAVR之前和之后的心脏损伤的程度,以及早期的变化,具有显著的预后价值.
- 在TAVR后对心脏损伤的分期有助于预测患者的长期结果.
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