经过透导管中枢替换后,左和右心室血液动力反应
Sebastian Ludwig1,2,3, Lena S Strotmann1, Benedikt N Schrage1,2
1Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Structural heart : the journal of the Heart Team
|August 5, 2024
概括
透导管 mitra 置换 (TMVR) 改善左心室 (LV) 功能,并在患有 mitra 吐 (MR) 的患者中逆转重塑. 在TMVR后降低的LV填充压力预测了更好的长期结果.
科学领域:
- 心脏病学 心脏病学
- 心血管外科心血管外科
- 生物医学工程 生物医学工程
背景情况:
- 透导管 mitra 置换 (TMVR) 是一种针对 mitra 吐 (MR) 的新疗法.
- 在TMVR后的MR消除对心室功能的血液动力学影响尚不清楚.
- 非侵入性压力-体积循环提供了一种方法来评估这些变化.
研究的目的:
- 研究TMVR对左心室 (LV) 和右心室 (RV) 功能的血液动力学影响.
- 通过使用非侵入性压力-体积循环来评估LV和RV性能变化.
- 评估TMVR后血液动力学变化的预后意义.
主要方法:
- 预计将在2016年5月至2022年8月期间招收26名接受TMVR治疗的患者.
- 在基线和TMVR后使用单拍心声谱估计LV压力-体积关系.
- 通过RV-肺动脉 (PA) 合和RV分数面积变化评估RV功能.
主要成果:
- 在26名患者中成功进行TMVR (77%的男性,81%的二次MR),基线LV喷射率为37%.
- 后TMVR显示LV填充压力降低 (VPed20) 和增加LV收缩性 (末缩弹性).
- RV功能 (RV-PA合,RV部分面积变化) 保持不变;VPed20减少预测更好的1年生存率.
结论:
- 非侵入性压力-体积循环显示了早期的LV反向重塑和TMVR后改善的收缩性.
- 在TMVR之后,RV的性能保持不变.
- 在TMVR后降低LV填充压力对死亡率和心力衰竭住院的预后有影响.
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