在Fontan患者的心血管结果与右与左单心室形态:一个多中心研究
Nabil Dib1, Marie-A Chaix1, Michelle Samuel1
1Montreal Heart Institute, Université de Montréal, Quebec, Canada.
JACC. Advances
|June 28, 2024
概括
在Fontan息后患有单心室右心室 (uRV) 的患者,与单心室左心室 (uLV) 患者相比,面临更高的心血管不良事件风险,包括心律失常和死亡.
科学领域:
- 心脏病学 心脏病学
- 儿童心脏病学 儿童心脏病学
- 遗传性心脏病是一种先天性心脏病.
背景情况:
- 根据主导心室形态,对Fontan息患者的长期结果存在有限的数据.
- 区分单心室右 (uRV) 和单心室左 (uLV) 室形态之间的结果至关重要.
研究的目的:
- 为了比较心房律不整,血栓栓塞事件,心脏移植和死亡的发病率,在RurV患者与uLV患者之间,在Fontan息后的形态.
- 为了确定与Fontan手术后的主导心室类型相关的差异性风险.
主要方法:
- 一项多中心回顾性队列研究,涉及384名全腔肺连接患者.
- 对复合结果 (心房律不整,血栓栓塞事件,移植,死亡) 的盲目判断以及对竞争风险的时间对事件分析.
主要成果:
- 在URV患者中,复合结局发生的频率更高 (100人/年3.7人),而在ULV患者中则更高 (100人/年1.7人).
- uRV形态赋予复合结果的风险>2倍 (HR: 2.17).
- uRV与心脏移植或死亡 (HR:9.09) 和心房失常 (HR:2.17) 的风险增加显著相关.
结论:
- 与具有uLV形态的患者相比,具有uLV形态的Fontan患者表现出较高的心血管不良事件发生率.
- 这些事件包括心房律不整,心脏移植和全因死亡率,突出显示主导心室类型的预后意义.
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