新型右心室功能参数可以识别短期不响应跨导管边缘到边缘修复对心肌吐的不响应者
Raffaella Mistrulli1, Tatyana Storozhenko2, Arthur Iturriagagoitia3
1Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium; Division of Cardiology, Sant'andrea Hospital, Rome, Italy.
The American journal of cardiology
|April 2, 2025
概括
先进的右心室 (RV) 功能指标,特别是基于三环状平面缩外流 (TAPSE) 的指标,有效地预测皮肤间膜修复 (PMVR) 后的主要不良心血管事件 (MACE). 这些RV评估有助于在术后识别高风险患者.
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.
- 膜心脏疾病 膜心脏疾病
背景情况:
- 副心脏反 (MR) 是一种常见的膜疾病,预后不佳.
- 皮肤膜修复 (PMVR) 提供预后益处,但许多患者仍然在一年内面临重大心血管不良事件 (MACE).
- 在PMVR后识别患有MACE风险的患者对于临床管理至关重要.
研究的目的:
- 通过使用MitraClip系统,评估高级右心室 (RV) 功能参数在PMVR后预测MACE的预后值.
- 确定特定的心声回声指数,可可靠地预测接受PMVR的患者的短期不良结果.
主要方法:
- 分析了一组连续60名患有症状重症MR的患者,接受PMVR.
- 心声学评估,包括基于三环状平面缩外流 (TAPSE) 的指数 (TAPSE/PASP,TAPSE/RVAD,TAPSE/RVAS) 和RV心肌工作指数,在基线,术后和6个月的随访中进行.
- 多变量分析被用来确定MACE的独立预测因子.
主要成果:
- 35%的患者在PMVR后的第一年内经历了MACE.
- 基线TAPSE/PASP,TAPSE/RVAS和TAPSE/RVAD是MACE的独立预测因素,显示出强大的预测能力 (AUC为0.80-0.85).
- RV心肌工作指数显示出较低的预测准确性 (AUC <0.60).
结论:
- 综合VR评估,特别是TAPSE基础的指数,可以确定PMVR后MACE风险较高的患者.
- 这些RV功能参数提供了宝贵的预后信息,以优化皮肤穿后对患者的管理.
- 在这种患者群体中,RV心肌工作指数在预测MACE方面似乎不那么可靠.
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