下肢再血管化后心脏功能下降的发生率和影响
Yasser Jamil1, Joshua Huttler2, Dana Alameddine3
1Department of Internal Medicine, Yale School of Medicine, New Haven, CT.
Annals of vascular surgery
|September 29, 2024
概括
在周围动脉疾病 (PAD) 患者下肢再血管化 (LER) 后心脏功能下降会增加死亡率,但不会影响主要不良肢体事件 (MALE). 这项研究强调了经过LER的PAD患者的风险.
科学领域:
- 心脏病学 心脏病学
- 血管外科 血管外科
- 医学成果研究研究成果
背景情况:
- 周围动脉疾病 (PAD) 影响四肢输液,需要下肢再血管化 (LER).
- 心脏功能下降是LER后的潜在并发症,但其对肢体结果的影响尚不清楚.
- 主要不良四肢事件 (MALE) 是LER之后的关键终点.
研究的目的:
- 在患有外周动脉疾病 (PAD) 的患者下肢再血管化 (LER) 后,调查心脏功能下降和主要不良四肢事件 (MALE) 之间的关联.
- 为了比较心脏功能下降后LER的患者和没有心脏功能下降的患者之间的死亡率和肢体相关结果.
主要方法:
- 对接受LER治疗PAD的患者电子健康记录的回顾性审查.
- 使用连续的胸前心脏回声图来评估心脏功能,将衰退定义为左心室喷射率 (ΔEF) 减少≥10%.
- 在心脏功能下降和心脏功能稳定组之间比较患者特征,MALE率,再干预和死亡率.
主要成果:
- 在926名患者中,24.0%的心脏功能下降. 这些患者患糖尿病,心力衰竭和周围手术出血的比率更高.
- 患有心脏功能下降的患者在3年随访后的死亡率显著上升.
- 卡普兰-梅尔分析表明,在两组之间,MALE或再干预率的自由率没有显著差异.
结论:
- 在PAD患者中,LER后心脏功能下降与整体死亡率增加有关.
- 尽管死亡率较高,心脏功能下降似乎不会显著影响肢体特定的结果,如MALE或重新干预率.
- 这表明,虽然心脏健康是LER后生存的关键因素,但肢体救援可能不会受到术后心脏变化的影响.
更多相关视频
04:44Author Spotlight: Enhancing Vascular Function and Physical Capacity in Cardiovascular Disease Through Novel Interventions and NIRS Technology
Published on: March 22, 2024
855
05:07Author Spotlight: Improved Localization and Monitoring of Coronary Flow Reserve Using Modified PLAX View in Mice
Published on: August 25, 2023
955
相关概念视频
01:23Peripheral Artery Disease V: Postoperative Nursing Management
4
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
4
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
3
Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
3
01:27Peripheral Artery Disease III: Interprofessional Care
3
Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
3
01:27Assessment of the Cardiovascular System III: Palpation
203
Palpation involves feeling the body to evaluate texture, size, consistency, and tenderness for assessing cardiovascular health. The following steps are organized in a head-to-toe order:
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above...
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above...
203
01:26Peripheral Artery Disease IV: Nursing Management
3
The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses,...
3
01:17Aortic Regurgitation IV: Nursing Management
16
A nurse managing a patient with aortic regurgitation begins with a comprehensive assessment, including a review of the patient's medical history, family history, and lifestyle factors. During the cardiac examination, the nurse listens for heart sounds and checks for signs of valve abnormalities. The nurse also observes for symptoms such as dyspnea, orthopnea, and paroxysmal nocturnal dyspnea and assesses the patient's endurance and daily activity tolerance.Based on the findings, the nurse...
16