在患有低流动性大动脉狭窄症的患者中进行左心室重塑,这些患者接受过导管大动脉置换
Carlo Mannina1, Lakshay Chopra1, Joseph Maenza1
1Department of Medicine.
The American journal of cardiology
|June 26, 2024
概括
在接受TAVR的低流动大动脉狭窄患者中,不适应的左心室重塑预测了更糟糕的结果. 这一发现改善了心力衰竭住院和死亡率的风险分层,超出了喷射率.
科学领域:
- 心脏病学 心脏病学
- 心声回声图 (Echocardiography) 是一种心声回声图.
- 心脏外科手术 心脏外科手术
背景情况:
- 老年人低流动性 (LF) 大动脉狭窄 (AS) 与正常中风体积的AS相比,与较差的预后有关.
- 在LFAS患者中,左心室 (LV) 重塑的预后意义仍然不清楚.
研究的目的:
- 调查LF重塑模式和临床结果之间的关联在患有严重LFAS的患者进行过导管大动脉置换 (TAVR).
- 为了确定LV改造是否提供了超出已建立的心声回声学参数的预后价值.
主要方法:
- 在463名严重LFAS患者中对LVR重塑的心声评估 (适应性与不适应性) 转诊TAVR.
- 随访390名TAVR患者的心力衰竭 (HF) 住院治疗和所有原因死亡,平均3年.
- 统计分析根据相关心声学参数进行调整.
主要成果:
- 在42.6%的患者中发现了不适应的LV重塑.
- 适应不良的重塑独立地与HF住院和死亡风险增加有关 (aHR 1.75).
- 这种关联在男性和女性中是一致的.
结论:
- 不适应性LV重塑是TAVR后心力衰竭再住院和LFAS患者死亡率的独立预测因素.
- 评估LV改造提供了超越LV喷射率的增量预后信息,用于LF AS的风险分层.
- 这些发现支持将LV改造评估纳入TAVR前评估.
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