在冠状动脉旁路移植之前的右心室扩张功能障碍:对5年随访结果的影响
Alexey N Sumin1, Anna V Shcheglova1, Nazeli D Oganyan2
1Federal State Budgetary Scientific Institution "Research Institute for Complex Issues of Cardiovascular Disease", Blvd. Named Academician L.S. Barbarasha, 6, 650002 Kemerovo, Russia.
Journal of clinical medicine
|February 26, 2025
概括
右心室扩张功能障碍 (RVDD) 对接受冠状动脉旁路移植 (CABG) 患者的5年结果产生负面影响. 患有RVDD的患者经历了手术后更糟糕的预后和更高的重大心脏不良事件 (MACE) 发生率.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
背景情况:
- 冠状动脉旁路移植 (CABG) 是冠状动脉疾病的常见手术.
- 评估影响CABG后长期结果的术前因素至关重要.
- 右心室扩张功能障碍 (RVDD) 是CABG后不良事件的潜在但未经研究的预测因素.
研究的目的:
- 评估RVDD对CABG后患者5年随访结果的影响.
- 确定长期重大心脏不良事件 (MACE) 的术前预测因素.
- 为了比较CABG后RVDD和没有RVDD的患者的预后.
主要方法:
- 对148名接受CABG (2017-2018) 的患者进行前性观察性研究.
- 术前评估包括左心室和右心室静脉缩和静脉缩功能的回声心电图.
- 5年的随访记录了MACE,包括死亡,心肌梗塞和重复血管化.
主要成果:
- 在CABG后5年内,MACE发生在29.1%的患者中.
- 手术前的RVDD与MACE增加显著相关 (p=0.037).
- 卡普兰-梅尔分析显示,在RVDD患者中,无MACE的存活率明显降低 (p=0.026).
结论:
- RVDD是CABG后不良结果的独立预测因素.
- 手术前的RVDD存在表明长期预后较差.
- 将RV扩张功能评估纳入术前评估可能会改善CABG患者的风险分层.
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