在左心房尾封闭后心力衰竭:来自LAAOS III随机试验的见解
Philipp Krisai1, Emilie P Belley-Cote2,3,4, William F McIntyre2,3,4
1Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland.
European journal of heart failure
|November 25, 2024
概括
在心脏手术期间的左心房尾封闭或切除 (LAAO) 并没有显著改变心力衰竭 (HF) 住院或死亡的风险. 这一发现表明,在接受手术的患者中,LAAO对于HF结果是安全的.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 心脏衰竭研究研究
背景情况:
- 左心房附属体 (LAA) 在天然尿素的生产中起作用.
- 在心脏手术期间进行LAA移除或封闭 (LAAO).
- 对LAAO对心力衰竭 (HF) 风险的潜在影响尚未完全理解.
研究的目的:
- 为了调查心力衰竭 (HF) 的发生率,左心房附属体封闭或移除 (LAAO) 后.
- 在LAAOS III试验中评估HF相关住院和HF死亡的复合结果.
- 评估LAAO在接受心脏手术的患者中关于HF发展的安全性.
主要方法:
- 随机试验 (LAAOS III) 涉及4811名患有心房动 (AF) 和CHA2DS2-VASc评分≥2的接受心脏手术的患者.
- 患者被随机分为接受手术LAAO或不接受手术.
- 使用临床和放射证据评估HF结果,与30天前/30天后的里程碑分析和子组分析.
主要成果:
- 在LAAO和没有LAAO组 (8.8%与7.8%,HR 1.12,p=0.25) 之间,复合HF结果 (住院治疗或死亡) 没有显著差异.
- 在前30天及以后的30天内,HF发病率在两组中都相似.
- 在各种子组中观察到一致的结果,包括基于先前的HF,年龄,性别和射出分数的结果.
结论:
- 在心脏手术期间左心房尾的封闭或切除不会改变心力衰竭相关住院或死亡的风险.
- 这些发现表明,LAAO在这种手术背景下与心力衰竭的风险增加无关.
- 进一步的研究可能会探索长期的HF影响和特定患者群体.
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