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根据流量和梯度模式,通过导管大动脉植入后心脏反应的差异

Hiroaki Yokoyama¹, Futoshi Yamanaka¹, Koki Shishido¹

¹Department of Cardiology and Catheterization Laboratories, Shonan Kamakura General Hospital, Okamoto 1370-1, Kamakura City 247-8533, Japan.

European heart journal. Cardiovascular Imaging

|September 10, 2024

概括

通过导管的大动脉植入 (TAVI) 治疗严重的大动脉狭窄症 (AS) 显示,与高梯度AS (HG-AS) 相比,在经典的低流量低梯度AS (cLFLG-AS) 中心脏功能得到改善. 矛盾的低流低梯度AS (pLFLG-AS) 患者经历TAVI后不太有利的结果.

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:

严重的大动脉狭窄 (AS) 需要干预,通过导管大动脉植入 (TAVI) 是主要的治疗方法.
基于流量梯度模式的患者分层对于理解TAVI结果至关重要.
有限的数据存在于不同AS流梯度组中TAVI后的心脏结构和功能变化.

研究的目的:

为了比较高梯度AS (HG-AS),经典低流低梯度AS (cLFLG-AS) 和悖论性低流低梯度AS (pLFLG-AS) 的患者在TAVI治疗后一年内心脏结构和功能变化.
评估不同AS流梯度模式对TAVI后死亡率和心脏重塑的影响.

主要方法:

一项大型多中心研究包括4523名因严重AS (2013-2019) 接受TAVI治疗的患者.
根据平均压力梯度,喷射率和中风体积指数,患者被分为HG-AS,cLFLG-AS和pLFLG-AS.
心声扫描在基线,术后和TAVI后一年评估了心脏结构和功能.

主要成果:

cLFLG-AS和pLFLG-AS组的两年全因死亡率比HG-AS大约高1.5倍.
在TAVI后,cLFLG-AS患者与HG-AS患者相比,LV维度的减少更大,LVEF增加.
与HG-AS相比,pLFLG-AS患者的LV维度减少较小,LVEF改善较差.

结论:

与HG-AS相比,cLFLG-AS患者在TAVI后一年经历了有利的LV重塑和改善的LVEF.
pLFLG-AS患者在TAVI后表现出不太有利的LV重塑和有限的LVEF改善.
流梯形模式显著影响TAVI之后的心脏结构和功能结果.

关键词:

大动脉狭窄症是什么超声心电图 (Echocardiography) 是一种心声回声仪.低流量低梯度的大动脉狭窄症穿过导管的大动脉植入装置.

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