多重并发症对老年患者长期死亡率的影响 经过过导管大动脉置换后的老年患者
Satoshi Higuchi1, Hidenari Matsumoto1, Ryota Masaki1
1Division of Cardiology, Department of Medicine, School of Medicine, Showa University, Shinagawa, Tokyo, Japan.
一个新的心脏和非心脏并发症风险评分 (3C评分) 显示,在接受过导管大动脉置换 (TAVR) 的老年患者中,对死亡率的预测有所改善. 这一分数比TAVR候选人的现有模型更好地分层风险.
科学领域:
- 心脏病学 心脏病学
- 老年医学 老年医学
- 医学风险分层医学风险分层.
背景情况:
- 接受过导管大动脉置换 (TAVR) 的老年患者经常患有多种心脏和非心脏并发症.
- 现有的风险评分不充分评估TAVR候选人的广泛的并发症.
研究的目的:
- 开发和验证一种新的预测模型,心脏和非心脏并发症风险评分 (3C评分),用于评估TAVR患者两年全因死亡率.
- 为了将3C评分的预测性能与已建立的风险评分进行比较:查尔森并发症指数 (CCI),EuroSCORE II和MELD-XI.
主要方法:
- 对226名接受TAVR治疗严重大动脉狭窄症的患者进行了回顾性评估.
- 使用多变量考克斯回归分析开发3C得分,确定关键的心脏 (减少LVEF,肺高血压) 和非心脏 (肝胆功能障碍,功能障碍,缓冲症) 预测因素.
- 使用C统计数据对3C评分,CCI,EuroSCORE II和MELD-XI进行预测准确性的比较.
主要成果:
- 3C评分表现出优异的预测能力,C统计值为0.767,明显优于EuroSCORE II (0.610),MELD-XI (0.580) 和CCI (0.476).
- 确定3C分数的关键预测因素包括左心室喷射率降低 (LVEF <40%),肺高血压,肝胆系统损伤,估计的球过率<30毫升/分钟/1.73米2,以及缓冲症.
- 这项研究包括226名患者,平均年龄为86±5岁.
结论:
- 肝胆道系统损伤和LVEF降低是TAVR老年患者需要考虑的关键并发症.
- 新的3C评分为接受TAVR的老年患者提供了更好的风险分层,有助于临床决策.
- 3C评分可以通过提供更准确的死亡率预测来提高复杂的TAVR候选者的管理.
更多相关视频
06:59Improved Registration of 3D CT Angiography with X-ray Fluoroscopy for Image Fusion During Transcatheter Aortic Valve Implantation
Published on: June 3, 2018
04:48Noninvasive Determination of Vortex Formation Time Using Transesophageal Echocardiography During Cardiac Surgery
Published on: November 28, 2018
相关概念视频
Ischemic Heart Disease: Overview
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
Chronic Obstructive Pulmonary Disease-III: Symptoms and Complications.
Symptoms of COPD can be classified as primary or systemic. Primary symptoms relate to reduced airflow, while systemic or extrapulmonary symptoms relate to COPD's broader impact on the body.
Primary Symptoms of COPD:
Pathophysiology of Heart Failure
Heart Failure Drugs: β-Blockers
Imbalances in Cardiac Output
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
Cardiac Output II: Effect of Stroke Volume on Cardiac Output
Preload
Preload refers to the initial elongation of the cardiac myocytes before contraction and is related to the volume of blood filling the heart at the end of diastole, or end-diastolic volume. The...
