门部署后立即改变左心室缩和扩张功能在跨导管大动脉置换:一个回顾性队列研究
Yuri Hayashi1,2, Ryuichiro Miyake3, Gardar Sigurdsson4
1Department of Anesthesia, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, IA, USA.
Journal of thoracic disease
|October 24, 2024
概括
通过导管的大动脉置换 (TAVR) 在部署后立即显著改善左心室 (LV) 缩和放缩功能,在患有低射出率 (EF) 的患者中. 在TAVR后,正常EF患者没有表现出这些即时的功能改善.
科学领域:
- 心脏病学 心脏病学
- 心血管外科心血管外科
- 医疗器械 医疗器械
背景情况:
- 过导管大动脉置换 (TAVR) 是对大动脉疾病的关键干预措施.
- 现有研究表明,TAVR在手术后改善了心和腹功能.
- 门部署后立即发生的血液动力学变化需要进一步调查.
研究的目的:
- 分析TAVR后左心室 (LV) 缩和透缩功能的即时手术内变化.
- 为了比较TAVR患者与正常和受损的LV射出分数 (LVEF) 之间的这些变化.
主要方法:
- 48名TAVR患者的回顾性队列研究 (2012年1月 - 2014年9月).
- 根据手术前的LVEF,患者被分为低EF (LVEF <50%) 和正常EF (LVEF ≥50%) 组.
- 在门部署之前和之后立即比较LVEF,横向e'和E/e'比率.
主要成果:
- 总体而言,TAVR队列显示LVEF有所改善 (51.7%至58.0%,P=0.007).
- 低EF组在LVEF (31.8%至45.5%,P=0.006),e' (5.0至6.2厘米/秒,P=0.004) 和减少E/e' (22.3至16.1,P=0.01) 中显著改善.
- 正常EF组显示e' (6.2至5.9厘米/秒,P=0.04) 的下降,而LVEF或E/e'没有显著变化.
结论:
- 在手术前 LVEF 较低的患者中,TAVR 导致 LV 缩和腹功能在手术内显著改善.
- 在TAVR患者中没有观察到这些即时的功能益处,这些患者在手术前的LVEF正常.
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