体质指数和心血管风险的性别特定差异对大动脉置换后的存活率产生不利影响
Suvitesh Luthra1,2, Hannah Masraf1, Davorin Sef1
1Department of Cardiac Surgery, Wessex Cardiothoracic Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Cardiovascular diagnosis and therapy
|September 15, 2025
概括
肥胖与高血压,糖尿病和吸烟等心血管风险因素相结合,与大动脉置换 (AVR) 后的生存率较差有关. 没有发现与身体质量指数 (BMI) 相关的性别特异性生存差异.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 肥胖问题研究研究
背景情况:
- 关于性别特异性肥胖对心血管风险和隔离性大动脉置换术 (AVR) 后存活率的影响的证据有限.
- 了解肥胖对术后结果和AVR后长期存活的影响至关重要.
研究的目的:
- 为了评估肥胖对隔离AVR后外科手术前期结果的影响.
- 为了评估肥胖对隔离AVR的长期存活的影响.
主要方法:
- 对2398名接受隔离AVR的患者进行了回顾性单中心研究 (2000年4月 - 2019年12月).
- 排除标准包括感染性内心炎,重新切口术,并发手术和紧急手术.
- 统变回归和Cox比例危险模型被用于分析死亡率和生存率的预测因素.
主要成果:
- 按精算计算的存活率在BMI组之间是相似的 (25-34.9 kg/m2与≥35 kg/m2).
- 高BMI与复合心血管风险因素 (高血压,糖尿病,吸烟) 显著恶化了长期生存率 (HR 1.93).
- 中度至严重的患者假肢不匹配 (PPM) 与更差的生存率有关,特别是在女性中.
结论:
- 结合高血压,糖尿病和吸烟的肥胖与隔离AVR后的不良长期生存有关.
- 在BMI组之间没有观察到长期存活的性别特异性差异.
- 中度至重度的PPM对性别的生存有不同的影响,对女性更有害.
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