肥胖对心脏移植后长期结果的影响
Darae Kim1, In-Cheol Kim2, Jong-Chan Youn3
1Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
概括
心脏移植患者的肥胖增加了移植功能障碍和死亡的风险. 在心脏移植手术之前,积极的肥胖管理对于更好的长期结果至关重要.
科学领域:
- 心脏病学 心脏病学
- 移植医学 移植医学
- 肥胖问题研究研究
背景情况:
- 肥胖是一个日益严重的全球健康问题,心脏移植 (HTx) 候选人的患病率越来越高.
- 虽然HTx接受者体质指数 (BMI) 的上升已被注意到,但肥胖患者的长期结果仍未得到充分记录.
研究的目的:
- 为了研究长期的移植后结果,特别是在肥胖的心脏移植接受者中.
- 为了比较肥胖的心脏移植接受者的结果与正常体重的人.
主要方法:
- 分析了1787名成年HTx接受者的队列 (1990年9月 - 2022年6月).
- 患者被分为BMI类别:体重不足 (<18公斤/米2),正常体重 (18.0-24.9公斤/米2),超重 (25-29.9公斤/米2) 和肥胖 (≥30公斤/米2).
- 主要结局是HTx后死亡率;次要结局包括移植功能障碍,排斥和不良心脏事件.
主要成果:
- 肥胖的接受者随着时间的推移显著增加,并且更容易患上糖尿病和高血压等并发症.
- 肥胖患者经历了更长的等待时间,并获得了更多的体型不足的捐赠者.
- 在中位数6年的随访期间,在肥胖的接受者中观察到更高的治疗排斥率和更低的HTx后生存率.
- 多变量分析证实,肥胖患者死亡风险较高,主要移植功能障碍和接受治疗的排斥.
结论:
- 肥胖的心脏移植接受者面临着显著增加的死亡风险,初级移植功能障碍和排斥.
- 这些发现强调了在心脏移植之前对多学科肥胖管理策略的关键需求,以改善患者的治疗结果.
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