在心力衰竭中进行过导管修复,并有中度至重度的 mitra 反
Stefan D Anker1, Tim Friede1, Ralph-Stephan von Bardeleben1
1From the Department of Cardiology of German Heart Center Charité and the Institute of Health Center for Regenerative Therapies, German Center for Cardiovascular Research (DZHK) Partner Site Berlin, Charité Universitätsmedizin (S.D.A., M.D., W.H.), the Department of Cardiology, Angiology, and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Campus Benjamin Franklin, the Berlin Institute of Health, and DZHK Partner Site Berlin (U.L.), Deutsches Herzzentrum der Charité, the Department of Cardiology, Angiology, and Intensive Care Medicine, Campus Charité Mitte, the Center for Cardiovascular Telemedicine, and DZHK Partner Site Berlin, Charité Universitätsmedizin (F.K.), Berlin, the Departments of Cardiology and Pneumology (S.D.A., M.D., G.H., W.S.) and Medical Statistics (T.F., M.P.) and the Clinical Trial Unit (J.H.), University Medical Center Göttingen, and the Heart Center, Department of Cardiology (W.S.), Georg August University of Göttingen, DZHK Partner Site Göttingen, Göttingen, the Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz (R.S.B., M. Geyer, T.F.R.), Mainz, the Department of Cardiology, Pulmonology, and Vascular Medicine, University Hospital Düsseldorf, Medical Faculty of the Heinrich Heine University Düsseldorf, and Cardiovascular Research Institute Düsseldorf, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University, Düsseldorf (M. Kelm), the Department of Rhythmology, University Heart Center Lübeck, University Hospital Schleswig-Holstein, Lübeck (K.-H.K.), the West German Heart and Vascular Center, Department of Cardiology and Vascular Medicine, University Hospital Essen, University Duisburg-Essen, Essen (T.R.), the Heart and Vascular Center, Bad Bevensen (U.S.), the Department of Internal Medicine I, Cardiology, University Hospital Jena, Jena (P.C.S.), the Institute for Cardiovascular Regeneration, Goethe University Frankfurt, and DZHK Partner Site Rhein-Main, Frankfurt am Main (A.Z.), the Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, and DZHK Partner Site Hamburg-Kiel-Lübeck, Hamburg (M. Karakas), the Department of Cardiology, Rostock University Medical Center, Rostock (A.Ö.), the Department of Medicine, Heart and Vascular Center, Division of Cardiology and Vascular Medicine, Johanniter Hospital Stendal, Stendal (M. Gross), the Mid-German Heart Center, Department of Cardiology, Angiology, and Intensive Care Medicine, University Hospital Halle, Halle (J.T.) - all in Germany; the Department of Medicine, University of Mississippi Medical Center, Jackson (J.B.); Baylor Scott and White Research Institute, Dallas (J.B., M.S.K.), Baylor Scott and White the Heart Hospital Plano, Plano (M.S.K.), and the Department of Medicine, Baylor College of Medicine, Temple (M.S.K.) - all in Texas; the Department of Translational Medicine, University of Ferrara, Ferrara (R.F.), the Cardiac Surgery Unit, IRCCS San Raffaele Scientific Institute, Milan (O.A.), ANMCO Associazione Nazionale Medici Cardiologi Ospedalieri Research Center, Heart Care Foundation, Florence (A.P.M.), and the Institute of Cardiology, Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, and the Department of Medical and Surgical Specialties, Radiologic Sciences and Public Health, University of Brescia, Brescia (M.M., M.A.) - all in Italy; the Division of Cardiovascular Medicine, Ohio State University, Columbus (W.T.A.); the Department of Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano (A.A.), and the Center for Translational and Experimental Cardiology, Department of Cardiology, University Hospital Zurich, University of Zurich, Zurich (F.R.) - both in Switzerland; the Heart Institute, Hospital Universitari Germans Trias i Pujol, Barcelona (A.B.-G., E.S.-V.), and the Department of Cardiology, Hospital Universitario Ramón y Cajal, and Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid (J.L.Z.) - all in Spain; the School of Cardiovascular and Metabolic Health, University of Glasgow, British Heart Foundation Glasgow Cardiovascular Research Centre, Glasgow, United Kingdom (J.G.F.C., M.C.P.); the Department of Cardiology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens (G.F.), and the Department of Transcatheter Heart Valves, Hygeia Hospital (K.S., M.C., P.K., K.P.), Athens, and the Department of Cardiology, St. Luke's Hospital (N.M., E.K.T.), and the European Interbalkan Medical Center (V.N., I.N., K.P.), Thessaloniki - all in Greece; the Department of Cardiology, Copenhagen University Hospital-Rigshospitalet, Copenhagen (F.G.); Unité Formation et Recherche Médecine, Université de Paris-Cité, site Bichat, Laboratoire de Recherche Vasculaire Translationnelle, INSERM, Groupe Hospitalier Bichat, Paris (A.V.); the Division of Cardiology, General Hospital Murska Sobota, Murska Sobota, and the Faculty of Medicine, University of Ljubljana, Ljubljana - both in Slovenia (M.L.); the Division of Cardiology and Structural Heart Diseases (G.S., W.W.) and the Department of Cardiology, Congenital Heart Diseases, and Electrotherapy (Z.K.), Medical University of Silesia, Katowice, the Institute of Heart Diseases, Medical University and University Hospital, Wrocław (K.R., P.P.), and the Department of Interventional Cardiology, Department of Radiology and Diagnostic Imaging, John Paul II Hospital, Krakow (Ł.W.) - all in Poland; and Centro Academico de Medicina de Lisboa, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal (F.J.P.).
在心力衰竭和功能性心肌回的患者中,透导管心肌门修复显著减少了心力衰竭住院和心血管死亡. 这种干预措施也改善了患者的健康状况,而不是仅仅用药物治疗.
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:
- 在心力衰竭患者中,功能性 mitra 反是常见的.
- 在这个人群中,通过导管修复额头门 (TMVR) 的疗效仍然不确定.
- 指南推的医疗治疗是当前的护理标准.
研究的目的:
- 为了评估TMVR与药物治疗相结合的疗效,与单独的药物治疗相比.
- 评估对心力衰竭住院,心血管死亡和患者报告的健康状况的影响.
主要方法:
- 一项随机对照试验 (RCT) 涉及505名心力衰竭和中度至重度功能性心肌吐的患者.
- 患者被分配到TMVR加药疗法或仅用药疗法.
- 主要终点包括心力衰竭住院或心血管死亡,单独心力衰竭住院,以及堪萨斯城心肌病问卷总结 (KCCQ-OS) 24个月后得分的变化.
主要成果:
- TMVR组的心力衰竭住院或心血管死亡率显著降低 (37.0对58.9事件每100个患者年;率比,0.64;P=0.002).
- 在TMVR组中,心力衰竭住院也显著减少 (每100个患者年发生26.9 vs 46.6;率比,0.59;P=0.002).
- 接受TMVR治疗的患者在12个月后KCCQ-OS得分得到了更大的改善 (平均差异10.9分;P<0.001). 特定于设备的安全事件很低 (1.6%).
结论:
- 透气管 mitra 修复,当添加到指导方针推的医疗治疗时,改善了心力衰竭和功能性 mitra 吐患者的结果.
- 这种干预措施导致住院病例减少,患者健康状况改善.
- 对于某些患者来说,TMVR是一种安全有效的治疗选择.
相关概念视频
Mitral Valve Prolapse II: Assessment and Management
Mitral Regurgitation I: Introduction
Mitral Regurgitation II: Clinical Features and Diagnostic Tests
Mitral Regurgitation III: Medical Management
Mitral Regurgitation IV: Nursing Management
Mitral Stenosis III: Medical Management


