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跨导管大动脉置换在患有各种流量梯度和射出分数形状的患者中的临床结果

Yoshiyuki Yamashita¹, Massimo Baudo¹, Serge Sicouri¹

¹Department of Cardiothoracic Surgery, Lankenau Heart Institute, Main Line Health Wynnewood, Pennsylvania, USA.

Anatolian journal of cardiology

|June 2, 2025

概括

通过导管的大动脉置换 (TAVR) 的结果因患者个人资料而异. 低流动性大动脉狭窄 (AS) 具有保留或减少的射出分数 (EF) 和低流高梯度AS具有保留的EF,在TAVR后的死亡率较高,相比正常流动高梯度AS.

科学领域:

心脏病学心脏病学
干预心脏病学干预心脏病学
心脏外科手术心脏外科手术

背景情况:

严重的大动脉狭窄 (AS) 需要干预,通过导管大动脉置换 (TAVR) 是主要的选择.
基于流量梯度和左心室喷射率 (EF) 的患者分层对于预测TAVR结果至关重要.

研究的目的:

为了比较不同流量梯度和EF配置文件的严重AS患者TAVR的临床结果.
为了确定可能在TAVR后死亡风险较高的患者子组.

主要方法:

追溯分析了846名使用新一代门进行TAVR的患者.
患者被分为五组:正常流量高梯度 (NF-HG),低流量高梯度与保存EF (LF-HG pEF),低流量高梯度与减少EF (LF-HG rEF),低流量低梯度与保存EF (LF-LG pEF) 和低流量低梯度与减少EF (LF-LG rEF).

主要成果:

整体1年和5年死亡率分别为13%和51%.
与NF-HG相比,在LF-HG pEF (HR 1.42),LF-LG pEF (HR 1.84) 和LF-LG rEF (HR 1.78) 组中观察到较高的全因死亡率.
在LF-LG组中,心血管死亡率显著增加.

结论:

低流量低梯度AS (保留和减少EF) 和低流量高梯度AS与保留EF与TAVR后所有原因死亡率的增加有关.
这些发现凸显了考虑TAVR患者风险分层的流量梯度和EF配置文件的重要性.

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