在不同类型的大动脉狭窄患者接受TAVI治疗的患者中,右心室与肺动脉合
Julius Steffen1,2, Melanie Lux1, Thomas J Stocker1,2
1Department of Medicine I, LMU University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
概括
右心室功能障碍,以减少右心室与肺动脉合 (RV/PAc) 显示,显著预测了经过过导管大动脉植入 (TAVI) 后的死亡率. 这一发现适用于不同的大动脉狭窄 (AS) 流量类型.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
背景情况:
- 右心室 (RV) 功能障碍往往被忽视在患者接受过导管大动脉植入 (TAVI) 为大动脉狭窄 (AS).
- 评估RV与肺动脉合 (RV/PAc) 可能提供关键的预后信息.
研究的目的:
- 评估RV与肺动脉合 (RV/PAc) 对TAVI后不同大动脉狭窄 (AS) 流型患者的死亡率的预测能力.
- 确定RV/PAc是否可以作为TAVI后可靠的风险分层工具.
主要方法:
- 分析了在2018年至2020年期间为AS接受TAVI的862名患者的队列.
- 根据ROC分析 (切断值0.512 mm/mmHg),患者被分为保存和减少的RV/PAc组.
- 使用统计调整和多变量建模来证实结果.
主要成果:
- 减少的RV/PAc与男性性别和增加的并发症有关.
- 减少RV/PAc组的两年全因死亡率明显高 (35.0%对15.4%),危险率为2.5.
- 在减少RV/PAc的患者中,心血管死亡率几乎翻了三倍.
- 在经典和矛盾的低流量低梯度AS子组中,RV/PAc始终具有预测性.
结论:
- 低RV/PAc,表明RV功能障碍,是TAVI后死亡率的强有力的预测因素,无论AS流型如何.
- 应将RV/PAc纳入TAVI患者未来的风险评估策略.
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