与欧洲-美国机构相比,亚洲的退行性腹回结果与欧洲-美国机构相比
Nadira Hamid1,2, Francesca Bursi3, Giovanni Benfari4,5
1National Heart Centre Singapore, Singapore.
JACC. Asia
|August 5, 2024
概括
亚洲的退行性部吐 (DMR) 患者接受的干预较少,长期死亡率高于西方患者,尽管早期修复的好处相似. 这凸显了对DMR管理的文化敏感方法的需要.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 医疗成像医学成像
背景情况:
- 退行性额回 (DMR) 的临床结果和干预值主要基于欧洲和美国的机构数据.
- 关于亚洲人群中DMR呈现,管理和结果的数据有限.
研究的目的:
- 为了比较来自亚洲机构 (ASIs) 的DMR患者的特征,治疗和长期结果,与欧洲和美国机构 (EAIs) 相比.
主要方法:
- 这项比较研究涉及737名来自香港和新加坡的DMR患者 (AsI队列) 和682名来自MIDA注册表的患者 (EAI队列).
- 分析包括临床表现,心声学发现,EuroSCORE II,干预率和长期死亡率.
- 倾向性得分匹配用于平衡队列之间的临床特征.
主要成果:
- 与EAI患者相比,AI患者年轻,症状较少,鼻节律较多,EuroSCORE II值较低.
- 尽管甲骨损伤严重程度和早期修复的好处相似,但ASI患者接受的干预措施较少 (55%vs77%在1年).
- AsI患者的长期死亡率显著增加 (调整后HR为1.60) 和治疗不足后倾向性得分匹配.
结论:
- 在ASI患者中体型较小可能导致在成像上低估心脏扩张.
- 虽然早期关节修复的好处是可比的,但对ASI患者的干预较少与长期死亡率过高有关.
- 调整管理策略以考虑成像和文化特点对于改善全球DMR结果至关重要.
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