严重大动脉狭窄症患者6分钟步行测试的预后价值
Norio Kanamori1, Yasuaki Takeji2,3, Tomohiko Taniguchi4
1Division of Cardiology, Shimada General Medical Center.
概括
6分钟的步行距离 (6MWD) 可靠地预测了严重的大动脉狭窄 (AS) 的结果. 步行速度较快 (≥300米) 的患者的死亡风险明显低于慢步行者 (<300米).
科学领域:
- 心脏病学 心脏病学
- 临床医学 临床医学
- 预测 预测 预测 预测 预测
背景情况:
- 在严重的大动脉狭窄 (AS) 中6分钟步行距离 (6MWD) 的预后价值仍未得到充分研究.
- 严重的AS需要了解预后标志物,以获得最佳的患者管理.
研究的目的:
- 评估6分钟的步行距离 (6MWD) 作为严重大动脉狭窄症 (AS) 的预后指标.
- 评估6MWD与不同治疗策略的死亡风险之间的关系.
主要方法:
- 一项前性多中心队列研究包括998名严重AS患者接受6分钟步行测试.
- 患者被分为快速 (≥300m) 和缓慢 (<300m) 步行者.
- 结果被评估为2.3年的中位随访期,包括所有原因的死亡率和大动脉置换 (AVR).
主要成果:
- 慢步行者 (<300米) 的3年累积死亡率 (31.7%) 与快步行者 (10.9%) 相比显著更高.
- 调整后的分析显示,慢步行者有2.36倍的全因死亡风险 (P<0.001).
- 这种预后关联持续不管最初的治疗策略 (AVR或保守管理).
结论:
- 6分钟的步行距离 (6MWD) 作为严重的大动脉狭窄症 (AS) 的强有力的预后标志物.
- 6MWD提供了宝贵的预后信息,无论选择的治疗策略如何,有助于临床决策.
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