在末期脏病患者的等待名单中,通过协议化心声学诊断的膜心脏病负担
Quan Yao Ho1,2, Ningyan Wong3, Ian Tatt Liew1,2
1Department of Renal Medicine, Singapore General Hospital, Singapore, Singapore.
Nephrology (Carlton, Vic.)
|October 23, 2025
概括
膜心脏病 (VHD) 是常见的末期脏病 (ESKD) 患者等待脏移植. 现有的和正在发展的VHD都显著增加了这些患者的死亡风险.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學.
- 移植医学 移植医学
背景情况:
- 膜心脏病 (VHD) 对健康构成重大负担,特别是在末期脏病 (ESKD) 患者中.
- 在ESKD患者中,VHD的患病率和预后影响对于已故捐赠移植 (DDKT) 患者的转诊仍然不那么明确.
- 在这种特定人群中了解VHD对于优化移植候选人和患者结果至关重要.
研究的目的:
- 为了确定ESKD患者中VHD的患病率和发病率,请参阅DDKT.
- 调查VHD对这一队列生存的影响.
- 在移植等候名单上的ESKD患者中识别与VHD相关的风险因素.
主要方法:
- 在2009年至2017年期间,对512名ESKD患者进行了DDKT转诊的回顾性队列分析.
- 纳入标准:至少进行过胸前心电图 (TTE) 一次,并进行随访,直到死亡或移植.
- 显著的VHD定义为中度或更严重的严重程度在心声回声学.
主要成果:
- 17.4%的患者有显著的基线VHD.
- 严重的VHD,严重的三腹吐,显著的大动脉狭窄症, mitra 狭窄症和大动脉吐独立地与增加全因死亡率有关.
- 15.1%的人出现了新发病或渐进的VHD,这也与更糟糕的生存率有关. 年龄,透析持续时间和矿物骨疾病与VHD发展/进展有关.
结论:
- 在被转介到DDKT等候名单的ESKD患者中,VHD的发病率很高.
- 既有且正在发展的VHD都是该群体生存率较低的重要预测因素.
- 这些发现强调了心脏评估对于被考虑进行移植的ESKD患者的重要性.
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