跨导管大动脉置换对左心房力学的影响:系统性审查和元分析
Thomas Meredith1,2,3, Lauren Brown4, Farhan Mohammed2
1Department of Cardiology, St Vincent's Hospital, Level 4, Xavier Building, 438 Victoria Street, Darlinghurst, NSW 2010, Australia.
European heart journal. Imaging methods and practice
|July 24, 2024
概括
过导管大动脉置换 (TAVR) 显著改善左心房 (LA) 机制,并减少LA重塑. 本研究量化了TAVR后LA功能和几何学的这些积极变化.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
背景情况:
- 左心房 (LA) 的形态和功能与左心室 (LV) 的负载条件密切相关.
- 有限的数据存在于跨导管大动脉置换 (TAVR) 对LA功能和几何的影响.
研究的目的:
- 量化TAVR与LA改造之间的关联.
- 从已发表的观察性研究中汇集数据,以评估TAVR对LA功能和几何学的影响.
主要方法:
- 系统性审查和对报告连续LA斑点跟踪心电回声学 (STE) 数据TAVR前后的研究的元分析.
- 包括LA面积,索引体积 (LAVi) 和标准室测量的研究.
- 根据早期 (<6个月) 和晚期 (≥6个月) 的随访心声谱对结果的分层.
主要成果:
- 在TAVR后观察到LAVi的平均减少为2.72mL/m2 (P<0.01).
- 整体LA储功能改善了3.71% (P < 0.01),在早期和晚期随访中都有显著改善.
- 在早期随访中恢复了LA收缩功能 (2.26%,P < 0.01),但在后期随访中没有显著改善 (1.41%,P = 0.05);LA增强功能改善了1.96% (P < 0.01).
结论:
- 根据STE的量化,TAVR与显著的反向LA改造和改进的LA机械有关.
- 在TAVR之后,这些观察到的LA重塑和功能变化的预后影响需要进一步调查.
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