严重大动脉狭窄症患者的右心室功能障碍在跨导管大动脉植入前和之后
Tomoka Zukeran1, Michiyo Yamano1, Tetsuhiro Yamano1
1Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Echocardiography (Mount Kisco, N.Y.)
|November 6, 2025
概括
在严重的大动脉狭窄 (AS) 患者中,右心室功能障碍 (RVD) 是常见的. 预先存在的RVD与左心室功能有关,而TAVI后长期存在的RVD可能会预测较差的结果.
科学领域:
- 心脏病学 心脏病学
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
- 膜心脏疾病 膜心脏疾病
背景情况:
- 右心室功能障碍 (RVD) 是严重的大动脉狭窄 (AS) 的显著预后指标.
- 通过导管大动脉植入 (TAVI) 后持续的RVD可能会影响患者的结果.
- 了解RVD患病率和预测因素对于管理接受TAVI治疗的AS患者至关重要.
研究的目的:
- 确定严重AS患者TAVI前后RVD的流行率.
- 为了确定与先前存在的RVD相关的因素.
- 为了确定与TAVI后长期RVD相关的因素.
主要方法:
- 对198名患有严重AS的患者进行了回顾性单中心研究.
- 由分数面积变化,右心室自由壁应变和三环状平面缩外流定义的RVD.
- 基线临床和心声学参数的多变量分析.
主要成果:
- 34.3%的患者有先前存在的RVD,与LV射出分数,LV中风体积指数和隔膜E/e'相关.
- 34.0%的患者在TAVI后一年出现了长期的RVD.
- 长时间的RVD与较低的LV中风体积指数,较大的相对壁厚,以及TAVI前较低的大动脉平均压力梯度有关.
结论:
- 在严重的AS中,RVD与特定的左心室参数和在基线时的舒张功能有关.
- 在TAVI后,LV中风体积,大动脉的压力梯度和相对壁厚可能预测持续的RVD.
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