成年人的亚膜大动脉狭窄:临床过程和长期结果
Adine R de Keijzer1,2, Frederike Meccanici1, Zoe A Keuning1
1Department of Cardiology, Erasmus University Medical Centre, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
European heart journal
|February 4, 2026
概括
以前接受过手术的亚膜大动脉狭窄症 (SAS) 的成年人生存率较低. 尽管SAS进展稳定,但发生了长期的临床事件,需要对SAS后果进行专注的随访.
科学领域:
- 心脏病学 心脏病学
- 遗传性心脏病是一种先天性心脏病.
- 成年人的先天性心脏病
背景情况:
- 亚膜大动脉狭窄 (SAS) 是一种影响大动脉的先天性心脏缺陷.
- 长期结果和SAS成年人的临床过程需要进一步调查.
研究的目的:
- 研究被诊断患有亚膜大动脉狭窄症 (SAS) 的成年人的临床过程和长期结果.
- 分析成人SAS患者的生存率,重新手术的需要和心血管事件.
- 探索心声回声学变化和影响结果的因素,包括之前的手术和性别.
主要方法:
- 在荷兰CONCOR注册表 (2001-2019) 中登记的312名成年SAS患者的前性队列研究.
- 评估所有原因的死亡率,SAS (重复手术),大动脉反 (AR) (重复手术) 和心血管事件.
- 使用线性混合效应模型对心声学参数 (峰值速度,IVST,LVPW) 的纵向分析.
主要成果:
- 与未经手术的患者相比,有史以来SAS修复的患者的15年未经调整的存活率较低 (P = .009).
- 15年后对AR进行 (重新) 手术的累积发病率为7.6%.
- SAS峰值速度呈现缓慢进展 (0.1 m/s第一个十年,0.3 m/s第二个十年);没有观察到快速进展.
结论:
- 经过先前修复的成年SAS患者的存活率大大降低,这表明表型更为严重.
- 长期临床事件发生率仍然相当,SAS进展稳定.
- 随访应优先考虑SAS的临床后果,可能允许在没有AR的轻度病例中更少频繁的心声回声扫描.
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