中年Fontan患者的临床特征和结果
Alexander C Egbe1, William R Miranda1, Ahmed E Ali1
1Department of Cardiovascular Medicine, Mayo Clinic Rochester, MN 55905, United States of America.
International journal of cardiology
|October 19, 2024
概括
与年轻人相比,中年Fontan患者面临着较高的心房律乱,器官功能障碍和死亡/移植的风险. 这凸显了在这个不断增长的人口中改善风险分层的必要性.
科学领域:
- 心脏病学 心脏病学
- 儿童心脏病学 儿童心脏病学
- 成年人的先天性心脏病
背景情况:
- 在当前的研究中,使用Fontan息治疗的中年个体的代表性不足.
- 了解它们独特的临床特征对于改善长期管理至关重要.
研究的目的:
- 描述Fontan息后中年患者的临床特征和结果.
- 将这些特征与年轻的成年Fontan幸存者的特征进行比较.
主要方法:
- 成年Fontan患者被分为"中年" (>40岁) 和"年轻成人"组.
- 临床评估包括心房失常,心力衰竭和肝功能.
- 根据死亡或心脏移植事件来评估结果.
主要成果:
- 中年患者 (14%) 呈现出较高的心房失常率,神经激素激活和肝功能障碍.
- 中年人群的5年和10年累计死亡/移植发生率明显高 (分别为45%与21%和64%与29%).
- 肺动脉压升高和MELD-XI得分与死亡风险增加相关.
结论:
- 大约14%的成年Fontan幸存者是中年,呈现出增加的并发病和死亡率.
- 这些发现强调了需要先进的风险分层来识别高风险个体.
- 建议在这个新兴的患者亚组中提前转诊进行心脏移植评估.
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