在患有左心室缩功能障碍的患者中,自扩张与气球可扩张的TAVI的五年结果
Masaaki Nakase1, Daijiro Tomii1, Annette Maznyczka1
1Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
American heart journal
|November 13, 2024
概括
在患有大动脉狭窄和减少喷射率的患者中,与气球可扩展THV相比,自我扩展的透气管心脏 (THV) 与更高的5年死亡率有关. 这凸显了THV设计在这个患者群体中的重要性.
科学领域:
- 心血管医学 心血管医学
- 干预心脏病学 干预心脏病学
- 生物医学工程 生物医学工程
背景情况:
- 透气管心脏 (THV) 设计对大动脉狭窄 (AS) 和左心室 (LV) 缩功能障碍患者的临床结果的影响尚不清楚.
- 左心室缩功能障碍是影响大动脉狭窄治疗后结果的关键因素.
研究的目的:
- 为了比较患有严重AS和减少LV射出分数 (LVEF) 的患者接受过导管大动脉植入 (TAVI) 的5年临床结果.
- 在这个特定的患者群体中,评估气球可扩展和自扩展THV之间的差异.
主要方法:
- 对伯尔尼TAVI注册表的回顾性分析.
- 包括接受TAVI的LVEF<50%的患者.
- 1:1的倾向-得分匹配,以平衡气球可扩展和自扩展THV组之间的基线特征.
主要成果:
- 技术成功率很高 (>85%) 在THV类型之间相似.
- 自扩张的THV显示了较低的平均跨膜梯度,但对膜吐的发病率更高.
- 在5年后,与气球可扩展THV相比,自扩展THV与明显更高的全因死亡率 (67.8%与55.8%) 相关.
结论:
- 在接受TAVI的LV系统功能障碍患者中,自我扩张的THV与5年死亡率的风险增加有关.
- 选择THV设计可能会显著影响严重AS和减少LVEF的患者的长期存活率.
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