在心房动中异常高的大动脉的分数:对跨导管大动脉置换的含义
Rajeev Masson1, Vuyisile T Nkomo2, David R Holmes2
1Department of Cardiovascular Diseases, Mayo Clinic Arizona, 13400 E Shea Blvd, Scottsdale, AZ 85259, USA.
European heart journal. Cardiovascular Imaging
|April 26, 2024
概括
与鼻节律 (SR) 患者相比,心房 (AF) 患者在经过过导管大动脉置换 (TAVR) 后有更严重的大动脉狭窄 (AS) 和更糟糕的结局. 这表明AS严重程度在AF患者中被低估,可能会延迟TAVR.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 心脏外科手术 心脏外科手术
背景情况:
- 多普勒平均梯度 (MG) 可能低估了心房 (AF) 与鼻节律 (SR) 的患者的大动脉狭窄 (AS) 的严重程度.
- 这种低估可能会推迟AF患者的及时干预.
- 过导管大动脉置换 (TAVR) 是严重AS的关键治疗方法.
研究的目的:
- 为了比较TAVR后AF和SR患者的结局.
- 通过计算机断层扫描 (计算机断层扫描) 来研究AF患者TAVR转诊的潜在延迟,使用大动脉气评分 (AVCS).
主要方法:
- 对820名因严重AS而接受TAVR的患者 (2013-2017年) 的回顾性分析.
- 在AF和SR组之间比较基线特征,AVCS和整体存活率.
- 统计分析以确定与TAVR后死亡率相关的因素.
主要成果:
- 与SR患者相比,患有AF (n=356) 的患者年龄较大,MG较低,但与SR患者相比,主动脉面积指数相似.
- 在AF患者中,AVCS的中位数显著高于AF患者 (男性P=0.044,女性P=0.025).
- 在TAVR后的中位生存时间在AF患者 (3.2年) 与SR患者 (5.4年) 相比,AF患者的中位生存时间更差,AF是死亡率的显著预测因素.
结论:
- 在AF患者中,年龄较大和AVCS较高表明AS在TAVR转诊时被低估了,并且更先进.
- 心房动与TAVR后更糟糕的结果有关.
- 目前的AS严重程度评估可能需要对AF患者进行调整.
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