在接受过导管大动脉植入的患者中,左心室喷射小部分:来自COMPARE-TAVI-1研究的见解
Preman Kumarathurai1, Christian Juhl Terkelsen2, Henrik Nissen3
1Department of Cardiology, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Denmark.
在大多数患者中,通过导管的大动脉植入 (TAVI) 改善了左心室喷射率 (LVEF). 然而,有些人经历持续的低LVEF,慢性心力衰竭和起器使用是关键预测因素.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 干预心脏病学 干预心脏病学
背景情况:
- 在大动脉狭窄 (AS) 中,左心室喷射率 (LVEF) 减少可能源于后载荷不匹配或收缩能力受损.
- 有限的数据存在于透过导管后的大动脉植入 (TAVI) LVEF变化和与持续低LVEF相关的因素.
研究的目的:
- 为了确定与TAVI后持续低LVEF相关的变量.
主要方法:
- 在COMPARE-TAVI 1试验中,随机选择了接受TAVI输血的患者,将其转移到不同的门类型.
- 患者根据基线LVEF (低≤40%与正常>40%) 进行分组.
- 分析了系列LVEF和12个月死亡率.
主要成果:
- 在151名基线LVEF较低的患者中,平均LVEF在TAVI后显著改善 (12个月后31%至52%).
- 20%的低基线LVEF患者在1年内持续LVEF≤40%;5%的正常基线LVEF下降至≤40%.
- 慢性心力衰竭,前TAVI心脏起器,基线LVEF,LV终端-透气直径,大动脉平均梯度和中风体积指数预测持续低LVEF.
结论:
- 在大多数具有低基线LVEF的患者中,TAVI有效改善LVEF.
- 一部分患者在TAVI后表现出持续的左心室功能障碍.
- 慢性心力衰竭,起器使用和基线LVEF是持续低LVEF的关键预测因素.
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