在接受过导管边缘到边缘修复的患者中,使用外导管心脏干扰来分类一次性 mitra 排泄
Danon Kaewkes1,2, Alon Shechter1,3, Vivek Patel1
1Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, California, USA.
概括
基于心脏损伤的初级额头气 (PMR) 的新分类预测了跨导管边缘到边缘修复 (TEER) 后的结果. 较高的损伤严重程度与更差的预后相关,有助于患者选择TEER.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 医疗成像医学成像
背景情况:
- 主要部反 (PMR) 管理受益于精细的患者选择和优化跨导管边缘到边缘修复 (TEER) 的时间.
- 一个新的分类系统基于心脏外侧干扰来分层PMR.
研究的目的:
- 评估PMR患者接受TEER的新分类系统的预后意义.
- 评估心脏外膜损伤程度对TEER后临床结果的影响.
主要方法:
- 接受MitraClip植入的322名PMR患者的队列根据术前心声扫描对外心脏损伤的评估被分为5组.
- 考克斯比例危险模型分析了PMR组与2年内所有原因死亡率或心力衰竭 (HHF) 再住院综合结果之间的关联.
主要成果:
- 这项研究包括322名接受TEER的PMR患者,不同程度的外侧心脏参与.
- 额外心脏损伤的严重程度增加 (组0-4) 与主要结局 (log-rank p=0.030) 的自由度下降显著相关.
- 多变量分析证实了额外心脏干扰作为主要结局的预测因素 (HR: 1.30; p=0.043),主要是由HHF驱动的.
结论:
- 基于外外心脏干扰的PMR的拟议分类系统表明TEER后临床结果的显著预后价值.
- 纳入这种分类可以改善风险分层,并指导PMR患者的最佳TEER时间.
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