在较不严重的功能性 mitrale 排泄中,MitraClip 还应该使用吗? 在RESHAPE-HF2研究中
Piera Capranzano1, Bianca Pellizzeri1, Luca Lombardo1
1Cardiovascular Department, Policlinico Hospital, University of Catania, Catania, Italy.
概括
使用MitraClip进行过导管边缘到边缘修复 (TEER) 有助于选择心力衰竭患者,患者的功能性米特拉反 (MR) 不那么严重. 仔细的患者选择是这个群体最佳结果的关键.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 心脏衰竭管理的管理
背景情况:
- 过导管端到端修复 (TEER) 适用于非手术候选人的严重功能性腹 (MR).
- 目前的指导方针建议TEER用于有效吐孔面积 (EROA) ≥0.40cm2且左心室没有过度重塑的患者.
- 以前的试验表明,TEER在不太严重的MR患者中的益处有限.
研究的目的:
- 评估TEER (MitraClip) 在有症状的心力衰竭和不太严重的功能性MR患者的疗效.
- 为了确定可能从TEER中获得更大的好处的较不严重的MR类别内的患者子组.
- 在这个特定的患者群体中,将TEER与单独的药物治疗进行比较.
主要方法:
- 这项研究分析了随机RESHAPE-HF2试验的数据.
- 被纳入的患者有症状性心力衰竭和不那么严重的功能性MR (平均EROA为0.23厘米2).
- 在TEER (MitraClip) 和单独使用药物治疗之间进行了比较.
主要成果:
- 与单独使用药物治疗相比,TEER显著减少了心力衰竭住院,改善了症状和生活质量.
- 在这个队列中,没有观察到TEER对死亡率有显著的益处.
- 在患者的特征表明心力衰竭恶化风险较高的患者中,TEER的益处更为明显.
结论:
- TEER (MitraClip) 在减少住院和改善选择性心力衰竭患者的生活质量方面提供了好处.
- 仔细选择患者至关重要,特别是识别那些心力衰竭恶化风险较高的人.
- 对于精心挑选的患有不太严重的MR的患者来说,TEER可能是一个有价值的选择,尽管他们接受了最佳的医疗治疗,但仍然有症状.
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