患有严重低流量,低梯度大动脉狭窄症患者的右心室功能障碍的患病率和预后意义,接受过导管大动脉置换术
Michele Bellino1, Germano Junior Ferruzzi1, Arturo Giordano2
1Department of Medicine, Surgery and Dentistry University of Salerno Baronissi Salerno Italy.
Journal of the American Heart Association
|November 4, 2024
概括
在为低流量,低梯度的大动脉狭窄而接受过导管大动脉置换的患者中,右心室功能障碍与更糟糕的结果有关. 对RV功能障碍的心声学评估有助于预测这些患者的预后.
科学领域:
- 心脏病学 心脏病学
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
- 干预心脏病学 干预心脏病学
背景情况:
- 右心室 (RV) 功能障碍对经过过导管大动脉置换 (TAVR) 的低流量,低梯度大动脉狭窄症 (LFLG-AS) 患者的临床影响尚不清楚.
- 大动脉狭窄是一个重要的心血管疾病,需要及时干预.
研究的目的:
- 调查先前存在的RV功能障碍是否会影响接受TAVR的LFLG-AS患者的临床结果.
- 在这个患者群体中评估VR功能障碍的预后价值.
主要方法:
- 分析了在意大利两个中心接受TAVR的392名LFLG-AS患者的队列.
- 通过心声学,RV功能障碍是由三状环状平面缩外流<17毫米定义的.
- 倾向性得分权重被用于调整RV功能障碍和无RV功能障碍患者之间的基线差异.
主要成果:
- 在TAVR之前,24.7%的患者表现出VR功能障碍.
- 在1年的随访中,RV功能障碍与所有原因死亡 (aHR,3.11),心血管死亡 (aHR,3.26) 和主要心血管和脑血管不良事件 (aHR,3.39) 的风险增加有显著关联.
- 根据RV功能,没有观察到中风或永久心脏起器植入率的显著差异.
结论:
- 使用三环状平面缩外流的VR功能障碍的心声评估可以提高LFLG-AS患者接受TAVR的预后分层.
- 在TAVR之前确定RV功能障碍对于风险评估和患者管理至关重要.
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