超导管大动脉置换等候名单失败 - 与心脏损伤阶段的相关性
Itamar Loewenstein1, Aviram Hochstadt2, Tami Jacoby1
1Cardiology Department, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel, Affiliated to The Faculty of Medical & Health Sciences, Tel-Aviv University, Tel-Aviv, Israel.
The Canadian journal of cardiology
|August 15, 2025
概括
心脏损伤阶段预测在等待跨导管大动脉置换 (TAVR) 的患者中预测不良事件. 晚期阶段表明住院和死亡风险较高,有助于TAVR候选人优先考虑.
科学领域:
- 心脏病学 心脏病学
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
- 干预心脏病学 干预心脏病学
背景情况:
- 越来越多的跨导管大动脉置换 (TAVR) 等候名单突出了有效的候选人优先级的需要.
- 与大动脉狭窄 (AS) 相关的心脏损伤 (CD) 阶段化为AS患者评估结构损伤提供了一个框架.
- 在患者等待TAVR时,可能会发生不良事件,这强调了改善风险分层的紧迫性.
研究的目的:
- 评估等待TAVR的患者心脏损伤 (CD) 阶段和AS相关不良事件之间的相关性.
- 为了确定CD分期是否可以预测等待列表失败 (WF) 在这个患者群体.
主要方法:
- 分析了在2018-2022年期间接受TAVR评估的904名症状严重AS患者的队列.
- 等候名单失败 (WF),定义为与AS相关的住院或死亡率,是主要结果.
- 多变量后勤回归确定了WF的预测因素,包括CD分期,脆弱性和低albuminemia.
主要成果:
- 在8.0%的患者中发生了等待列表失败 (WF).
- 在心声回声学上较高的CD阶段与WF风险增加相关.
- 结核病的分期是WF的独立预测因素 (连续:HR 1.66;分类阶段≥3:HR 2.24),以及脆弱性和低albuminemia.
结论:
- 晚期心脏损伤 (CD) 阶段是等待TAVR的患者中不良事件,包括住院和死亡率的重要独立预测因素.
- CD分期为优先考虑TAVR候选人和管理等待名单风险提供了有价值的信息.
- 将CD分期集成到临床实践中可以帮助优化TAVR候选人选择并改善患者的治疗结果.
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