在患有严重大动脉狭窄症患者的手术前计算机断层扫描检测到的大脑血管疾病,这些患者正在接受大动脉置换
Ko Yamamoto1, Hiroyuki Ueda2, Daiji Uchiyama2
1Department of Cardiology Kokura Memorial Hospital Kitakyushu Japan.
Journal of the American Heart Association
|July 9, 2024
概括
在接受大动脉置换的严重大动脉狭窄患者的手术前CT扫描中,大脑血管疾病的流行与更糟糕的结果有关. 这种风险仍然存在,无论之前是否有中风史.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 放射学 放射学是一门学科.
背景情况:
- 有限的数据存在于大脑血管疾病的患病率和影响之前的动脉置换 (AVR).
- 严重的大动脉狭窄患者经常接受手术前计算机断层扫描 (CT) 扫描.
- 在CT上检测到脑血管疾病可能会影响患者的治疗结果.
研究的目的:
- 为了确定严重的大动脉狭窄患者在手术前CT上脑血管疾病的患病率.
- 为了比较AVR之前检测到的脑血管疾病和没有脑血管疾病的患者之间的临床结果.
- 评估以前中风病史对这一队列的结果的影响.
主要方法:
- 对567名患有严重大动脉狭窄的患者进行了回顾性分析,他们接受了AVR.
- 程序前的CT扫描被评估为脑血管疾病 (慢性脑梗塞或出血).
- 临床结果,包括全因死亡或中风,在3年内在组之间进行了比较.
主要成果:
- 35.3%的患者在术前CT时患有脑血管疾病;只有28.5%的患者有症状性中风史.
- 在患有脑血管疾病的患者中,死亡或中风的3年发病率显著更高 (40.7%vs24.1%).
- 脑血管疾病仍然是不良结果的独立预测因素 (HR,1.42;P=0.04),无论中风史.
结论:
- 严重的大动脉狭窄患者中很大一部分在手术前CT上没有检测到脑血管疾病.
- 在手术前CT检测到的脑血管疾病与AVR后更糟糕的临床结果有关.
- 术前脑血管疾病影响结果,无论患者有症状性中风史.
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