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透气导管大动脉植入后左心房变形的预后影响和变化
Steele C Butcher1,2, Kensuke Hirasawa1,3, Maria Chiara Meucci1,4
1Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Albinusdreef 2, 2300 RC Leiden, The Netherlands.
European heart journal. Cardiovascular Imaging
|July 10, 2024
概括
较高的左心室储应变定义透析功能障碍 (LARS-DD) 等级预测过导管大动脉植入 (TAVI) 后严重的大动脉狭窄患者的死亡率. 在TAVI后的LARS,而不是在TAVI前的LARS,与新出现的心房动有关.
科学领域:
- 心脏病学 心脏病学
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
- 心脏外科手术 心脏外科手术
背景情况:
- 严重的大动脉狭窄 (AS) 带来了重大风险.
- 过导管大动脉植入 (TAVI) 是严重AS的常见治疗方法.
- 左心房储压力定义的透析功能障碍 (LARS-DD) 是一个潜在的预后标志物.
研究的目的:
- 为了评估LARS-DD等级的预后价值在接受TAVI治疗严重AS的患者中.
- 调查前后TAVI LARS和新发动的心房动之间的关联.
主要方法:
- 斑点跟踪回声心脏图用于评估LARS-DD等级 (等级0/1: ≥24%,等级2: 19-24%,等级3: <19%).
- 包括601名接受TAVI的严重AS患者.
- 对患者进行了随访,以查看所有原因的死亡率和新发性心房动.
主要成果:
- 增加的LARS-DD等级独立地与更高的全因死亡率相关 (aHR为每等级增加1.28,P=0.007).
- 在TAVI后的LARS (aHR 1.14 per 1% <20%,P=0.0009),但不是在TAVI前的LARS,与新发动的心房动独立相关.
结论:
- 较高的LARS-DD等级是严重AS患者TAVI后长期死亡率的独立预测指标.
- 在TAVI后的LARS与新发性心房的发展有显著的关联.
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