在接受高风险PCI与Impella的患者中,右心室功能障碍
Karl-Philipp Rommel1, Guillaume Bonnet2, Lavanya Bellumkonda3
1Department of Cardiology, Heart Center at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany, University Medical Center Mainz, Mainz, Germany; Clinical Trials Center, Cardiovascular Research Foundation, New York, New York, USA.
Journal of cardiac failure
|October 10, 2024
概括
在接受Impella支持的高风险穿皮冠状动脉干预 (HRPCI) 的患者中,右心室功能障碍 (RVD) 与更糟糕的长期结果有关. 尽管有有效的重血管化,但RVD预测90天MACCE和一年死亡率增加.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 心脏成像 - - 心脏成像
背景情况:
- 右心室功能障碍 (RVD) 是心力衰竭的一个关键预后指标.
- 在使用Impella支持的高风险穿皮冠状动脉干预 (HRPCI) 中,RVD对结果的影响尚不清楚.
研究的目的:
- 调查基线RVD对接受Impella支持HRPCI的患者临床结果的影响.
- 评估程序的成功,短期和长期预测与RVD状态相关.
主要方法:
- 来自PROTECT III研究的患者根据RVD的存在进行了分层,通过心声回声学进行评估.
- 定义的RVD标准包括分数面积变化<35%,三环状平面缩外流<17mm,或S波<9.5cm/s.
- 评估了手术结果,90天的主要心脏和脑血管不良事件 (MACCE) 和1年死亡率.
主要成果:
- 239名患者中有124名患有RVD,与较低的LVEF和较高的BUN相关.
- 在低血压发作,Impella支持持续时间或住院死亡率方面没有显著差异.
- 观察到更高的90天MACCE率和RVD作为1年死亡率的预测因素.
结论:
- 在Impella支持的HRPCI患者中的RVD表明更先进的双心脏衰竭.
- 即使在RVD.的情况下,Impella也能促进有效的重血管化.
- 尽管程序成功,但RVD与不利的长期预后有关.
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