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在TAVR后植入心脏起器的患者中,心室节奏负担的预后作用
Abdullah Orhan Demirtas1, Abdullah Yildirim1, Mukremin Coskun1
1Department of Cardiology, University of Health Sciences, Adana City Training and Research Hospital, 01230 Adana, Türkiye.
Medicina (Kaunas, Lithuania)
|October 29, 2025
概括
跨导管大动脉置换 (TAVR) 和永久起器 (PPM) 植入后的高心室节奏 (VP) 负担不会增加死亡率. 然而,显著的VP负担与更高的心力衰竭住院风险和更差的心声回声检查结果有关.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 心脏电生理学 心脏电生理学
背景情况:
- 永久心脏起器 (PPM) 植入是通过导管的大动脉置换 (TAVR) 后的常见并发症.
- 在这些患者中,高心室节奏 (VP) 负担的长期预后影响仍然不完全理解.
研究的目的:
- 调查高VP负担与TAVR后的临床结果之间的关联.
- 为了评估VP负担对死亡率,心力衰竭 (HF) 住院和心声学参数的影响.
主要方法:
- 对118名接受TAVR,需要PPM植入的患者进行了回顾性单中心队列研究.
- 患者根据1个月的VP负担分为两组:<85%和≥85%使用X-tile分析.
- 基线特征,程序结果和长期终点的比较,包括所有原因死亡率和HF住院治疗.
主要成果:
- 患有VP≥85% (38.1%) 的患者表现出类似的基线人口统计数据,但基线LVEF较高,功能更好.
- 高VP负担 (≥85%) 与所有原因死亡率的增加无关 (HR:1.81,p=0.182).
- VP ≥85%与死亡率和HF住院的复合终点风险更高 (HR:2.36,p=0.012) 有显著的关联,并在1年的随访中导致LVEF较低和e-SPAP更高.
结论:
- 在患有PPM的TAVR患者中,高VP负担 (≥85%) 与增加的死亡率无关.
- 显著的VP负担预测心力衰竭住院的风险更大.
- 高VP负荷与心声回声学恶化有关,包括减少LVEF和增加肺动脉静脉压.
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