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与平均梯度相比的加速时间/射出时间比率作为TAVR后临床结果的预测指标

Tamari Lomaia¹, Besir Besir¹, Shivabalan Kathavarayan Ramu¹

¹Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA.

JACC. Cardiovascular interventions

|September 24, 2025

概括

过导管大动脉置换 (TAVR) 后的加速时间/喷射时间 (AT/ET) 比率可以预测心力衰竭住院情况. 这种血液动力学测量可以解释自扩展和气球扩展之间的结果差异.

科学领域:

心脏病学心脏病学
医疗器械医疗器械
心声回声扫描 (Echocardiography) 是一种心声回声扫描.

背景情况:

过导管大动脉置换 (TAVR) 是严重的大动脉狭窄症的关键治疗方法.
大动脉平均梯度 (MG) 评估了假肢功能,但被心脏输出所混.
需要新的血液动力学参数来评估TAVR的结果.

研究的目的:

为了研究TAVR的血液动力学,使用加速时间/喷射时间 (AT/ET) 的比率.
为了比较AT/ET和MG对TAVR后临床结果的预测值.

主要方法:

对1900名接受TAVR (2016-2020) 的患者进行了回顾性队列研究.
大动脉AT/ET在TAVR后3个月内测量.
根据AT/ET分组的患者≥0.35与<0.35;结果包括心力衰竭住院治疗 (HFH) 和死亡率.

主要成果:

AT/ET≥0.35与1年高血压增加有关 (P<0.001),但不与死亡率有关.
大动脉MG>20mmHg没有显示出1年HFH或死亡率的显著差异.
在自扩展式 (23.2%) 和气球可扩展式 (12.7%) 门中,更高的AT/ET更为常见 (P = 0.001).

结论:

在TAVR后的AT/ET≥0.35可能预测像HFH一样的临床结果.
AT/ET可以解释不同TAVR门类型之间的血液动力学和结果差异.

关键词:

气球扩展的气球扩展超声心电图 (Echocardiography) 是一种心声回声仪.自扩展的自扩展.

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