在大动脉狭窄中严重的额头环状化的预后意义:对大动脉置换结果的影响
Valeria Pergola1, Dan-Alexandru Cozac1,2, Maria Teresa Savo1
1Cardiology Unit, Cardio-thoracic-vascular, and Public Health Department, Padova University Hospital, Padova 35128, Italy.
概括
严重的 mitra annulus 化 (MAC) 独立地预测了在接受主动脉置换 (AVR) 的患者中更糟糕的心血管结果. 这一发现表明,MAC是影响AVR后患者护理的关键预后因素.
科学领域:
- 心脏病学 心脏病学
- 心脏成像 - - 心脏成像
- 膜心脏疾病 膜心脏疾病
背景情况:
- 与老化相关的关系之外,中枢环结石化 (MAC) 越来越多地得到认可.
- 新出现的证据将MAC与性大动脉狭窄症 (AS) 联系起来,但其在接受大动脉置换 (AVR) 的AS患者的预后意义需要进一步调查.
研究的目的:
- 评估心脏CT衍生的MAC对严重AS患者进行AVR的心血管结果的影响.
- 确定MAC严重程度是否是AVR后不良事件的独立预测因素.
主要方法:
- 使用手术前对比增强心脏CT (CCT) 来量化MAC严重性,使用Guerrero CCT衍生的MAC得分.
- 评估的主要心血管不良事件 (MACE),包括心血管死亡率,心律失常,中风和心力衰竭住院治疗,超过AVR后60个月.
- 采用多变量考克斯模型来确定MACE和死亡率的独立预测因素.
主要成果:
- 包括313名患有严重AS的患者进行AVR;65.4%患有MAC (12.1%严重MAC).
- 严重的MAC,中度至严重的甲状腺吐和STS得分>2.5%是MACE的独立预测因素 (p <0.05).
- 严重的MAC和STS得分>2.5%,独立预测所有原因死亡率 (p <0.05).
结论:
- 严重的MAC是AVR患者心血管不良结果的独立预测因子.
- 将MAC评估纳入临床评估可能会显著改变患者管理策略.
- 在AS和AVR的背景下,MAC严重程度提供了有价值的预后信息.
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