患有退行性心肌修复的患者心室节律失常:患病率和对生存的影响
Betemariam Sharew1, Joanna Chikwe2, Aminah Sallam2
1Department of Cardiac Surgery, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH.
The Journal of thoracic and cardiovascular surgery
|August 23, 2025
概括
无节律的 mitra 脱不影响手术修复后的生存,但与跨导管边缘修复 (TEER) 相关. 需要进一步研究以确定最佳的治疗策略.
科学领域:
- 心脏病学
- 心脏外科
- 干预心脏病学
背景情况:
- 室内节律失常 (VAs) 发生在一小部分患有关 (MVP) 的患者中.
- 静脉动脉在退行性心肌修复后对术后生存的影响尚不清楚.
- 节律失调的MVP (AMVP) 定义为退行性腹和心血管.
研究的目的:
- 在患有AMVP和没有AMVP的患者中,比较退行性 mitralia修复后的长期存活率.
- 评估二次结果,包括植入式心脏除器 (ICD) 和与VA相关的再入院.
- 为 AMVP 患者提供治疗选择.
主要方法:
- 对国家保险数据库的回顾性分析.
- 在接受手术修复或TEER的AMVP患者和没有AMVP患者之间比较5年生存率,ICD植入和与VA相关的再入院.
- 根据基线差异进行多变量调整;随访时间中位数为3. 8年.
主要成果:
- 在20980名患者中,有1745人患有AMVP.
- 手术修复后的五年生存率为AMVP患者的86%,而非AMVP患者的81% (HR: 0. 79, p=0. 02).
- 在TEER后的5年存活率为AMVP患者中的34%,而非AMVP患者中的43% (HR:1.26,p<0.001);在AMVP患者中,手术后的ICD率更高.
结论:
- 在外科手术修复后,AMVP与生存率的降低无关.
- 在TEER后,AMVP与生存率显著降低有关.
- 需要进行前性研究以了解AMVP的病理生理学,并指导治疗决策.
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