左心室射出小部分改善的预后影响 跨导管大动脉置换后的左心室射出小部分改善
Jakob Johannes Reichl1,2, Thorald Stolte1,3, Shihui Tang1
1Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, 4031 Basel, Switzerland.
Journal of clinical medicine
|July 13, 2024
概括
通过导管的大动脉置换 (TAVR) 改善了结果. 在TAVR之前保存的左心室喷射分数 (LVEF) 预测了更好的结果,手术后早期的LVEF改善与更好的生存率和更少的重大心血管不良事件有关.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 心脏外科手术 心脏外科手术
背景情况:
- 过导管大动脉置换 (TAVR) 是手术大动脉置换 (SAVR) 的安全替代方案.
- 严重的大动脉狭窄和反会对左心室喷射率 (LVEF) 产生负面影响,但TAVR可能会改善LVEF.
- 在TAVR后的LVEF改善的预后意义需要进一步调查.
研究的目的:
- 评估TAVR前 LVEF 损伤的预后影响.
- 评估早期LVEF改善与TAVR后患者结果之间的关联.
主要方法:
- 在第三级大学医院接受TAVR的患者的未来注册.
- 在基线,1个月和每年进行的跨胸腔心声扫描 (TTE).
- 显著的LVEF改善定义为TAVR后30天≥10%的相对增加.
主要成果:
- 1556名患者有基线LVEF数据;14.3%的LVEF严重减少 (<40%).
- 在LVEF受损患者中,40.4%的患者在30天后显著改善 (≥10%).
- 保存的基线LVEF预测了更好的结果. 改善LVEF与1年生存益处和较低的5年MACE率相关.
结论:
- 在TAVR前保存的LVEF是改善患者结果的独立预测指标.
- 在TAVR后早期的LVEF改善与延长存活率和减少主要心血管不良事件有关.
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