在TAVR后的临床结果,对于低梯度和非常低梯度大动脉狭窄症患者
Besir Besir1, Tamari Lomaia1, Shivabalan Kathavarayan Ramu1
1Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA.
Progress in cardiovascular diseases
|September 10, 2025
概括
患有非常低梯度大动脉狭窄症 (AS) 的患者在经过透气管大动脉置换 (TAVR) 后经历了更糟糕的结果. 较低的中风体积指数和射出分数预测了这些较低的梯度,这表明对低梯度AS患者的早期干预.
科学领域:
- 心脏病学 心脏病学
- 心血管外科心血管外科
- 干预心脏病学 干预心脏病学
背景情况:
- 减少左心室喷射率 (LVEF) 和低流量状态与大动脉狭窄 (AS) 的较差结果有关.
- 与低梯度AS相比,具有非常低梯度AS的患者的临床结局在透气管后的大动脉置换 (TAVR) 后尚不清楚.
研究的目的:
- 为了研究下基线大动脉 (AV) 平均梯度对接受TAVR的低梯度AS患者的临床结果的影响.
- 在这个患者群体中确定较低基线AV平均梯度 (MG) 的预测因素.
主要方法:
- 在2016-2020年期间接受TAVR的患者 (>18岁) 的回顾性队列研究,AV面积<1厘米2和AVM <40毫米度.
- 门中的门TAVR程序的排除.
- 根据基线AV MG,患者被分为三类;生存分析用于比较死亡率和心力衰竭住院率.
主要成果:
- 最低AV MG第三位 (非常低梯度AS) 的患者与最高第三位 (低梯度AS) 相比,死亡率更高 (HR:2.07,95% CI [1.2-3.6]).
- 较低的中风体积指数 (SVI),降低的LVEF,心房动和中度至严重的三回 (TR) 与较低的基线AV MG相关.
结论:
- 与低梯度AS相比,非常低梯度AS与TAVR后显著更差的临床结果有关.
- 临床因素,如较低的SVI,较低的LVEF和心房动,预测存在非常低梯度的AS.
- 建议在低梯度AS患者早期进行干预,以改善临床结果.
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