心脏损伤和通过导管的大动脉置换患者的结果 - - 一项COMPARE-TAVI 1试验子研究
Rasmus Carter-Storch1, Christian Juhl Terkelsen2,3, Henrik Nissen1
1Department of Cardiology, Odense University Hospital, Odense, Denmark.
European heart journal. Cardiovascular Imaging
|October 31, 2025
概括
过导管大动脉干预 (TAVI) 后的严重心脏损伤 (第3至第4阶段) 没有增加无益性风险,即使是并发症. 患者在TAVI后表现出类似的功能改善,无论心脏损伤阶段或并发症如何.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 心脏成像 - - 心脏成像
背景情况:
- 通过导管的大动脉干预 (TAVI) 是严重的大动脉狭窄症 (AS) 的关键治疗方法.
- 心脏损伤 (CD) 的分期对于TAVI后的预后至关重要.
- 晚期CD (3-4阶段) 对TAVI结局的影响,特别是伴随疾病的影响,需要进一步调查.
研究的目的:
- 评估TAVI后第3-4期心脏损伤 (CD) 的预后意义.
- 为了确定影响右心功能的并发症是否会改变TAVI后晚期CD的预后.
主要方法:
- 对985名因严重AS而接受TAVI治疗的患者进行了回顾性分析.
- 患者分为:CD阶段0-2;CD阶段3-4与孤立的AS;CD阶段3-4与并发症.
- 无用性定义为死亡或NYHA 3-4级呼吸障碍在TAVI后的一年.
主要成果:
- 83%的人患有CD阶段1-2,10%患有CD阶段3-4孤立AS,6%患有CD阶段3-4并发病症.
- 在各组中,徒劳率相似 (10%对17%对15%,p=0.09).
- 基线和一年的NYHA类在CD阶段3-4组中更高 (p<0.01),但6分钟步行测试距离同样有所改善.
结论:
- 影响右心功能的并发症在接受TAVI治疗的3-4期CD患者中很常见.
- 在TAVI后,3-4期CD与无效性风险增加无关,无论伴随疾病如何.
- 患有晚期CD的患者在TAVI后的功能收益与患有不太严重CD的患者相似.
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