在患有左心室功能障碍的患者中,与心力衰竭相关的结果,经过皮肤慢性全塞重血管化
Pierluigi Lesizza1, Lennert Minten1,2, Ella Poels3
1Department of Cardiovascular Medicine, University Hospitals Leuven, 3000 Leuven, Belgium.
Reviews in cardiovascular medicine
|July 30, 2024
概括
在左心室射出分数减少 (<40%) 的患者中,成功的慢性全封闭 (CTO) 穿皮冠状动脉干预 (PCI) 降低了心力衰竭住院率. 这种安全有效的程序有望改善这一高风险群体的治疗结果.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 心脏衰竭管理的管理
背景情况:
- 慢性全闭 (CTO) 和严重的左心室 (LV) 缩功能障碍是冠状动脉疾病的不良预后指标.
- 之前的研究重点关注CTO重血管化的对死亡率和心脏功能的影响,但不是特别关注LV功能障碍患者的心力衰竭事件.
研究的目的:
- 评估CTO穿皮冠状动脉干预 (PCI) 的成功率和安全性,对LV喷射小部分<40%的患者.
- 评估成功的CTO PCI对心力衰竭住院治疗 (HFH),心房动 (AF) 和功能恶化 (WRF) 的影响.
主要方法:
- 在三个转诊中心进行的CTO PCI的前性分析.
- 纳入标准:在1435名CTO PCI中,132名患者的LV喷射分数<40%.
- 随访时间中位数为23.18个月.
主要成果:
- 对于CTO PCI的程序成功率为82.5%,可接受的程序周并发症 (9.1%).
- 成功的CTO PCI与心力衰竭住院率显著降低有关.
- 在成功和失败的PCI组之间,无因死亡,心血管死亡,非致命性MI,WRF或AF没有显著差异. 较高的eGFR和成功的PCI预测了较低的HFH风险.
结论:
- CTO PCI是安全和有效的,在患者减少的LV缩功能 (EF<40%).
- 成功的CTO PCI独立地与随访期间降低HFH风险有关.
- 需要进一步的研究,以在更大的队列中证实这些发现.
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