JACC:经导管二尖瓣置换术后的2年预后

2017-08-22 xiangting MedSci原创

使用FORTIS瓣膜的TMVR是可行的。TMVR后的MR降低在2年随访期间得到了维持,并且没有观察到晚期装置相关事件。

这项研究旨在探讨使用FORTIS瓣(Edwards Lifesciences,Irvine,California)的经导管二尖瓣置换术(TMVR)后的晚期(2年)结局。在严重的二尖瓣返流(MR)患者中,TMVR后的长期临床预后尚没有报道。该多中心登记包括严重MR患者,在临床使用计划中使用FORTIS瓣膜进行TMVR。在基线、30天、1年和2年的随访中收集临床和超声心动图数据。纳入13例重度MR患者(71±8岁,10例男性,logistic欧洲心脏手术风险评估系统评分= 23.7±12.1%)。大多数(76.9%)患者的MR是缺血性起源的,平均左心室射血分数为34±9%。术后30天内10例(76.9%)取得技术上成功,5例(38.5%)患者死亡。30天随访时,平均偏斜梯度为3±1 mm Hg,无中度重度残留MR或左心室流出道阻塞病例。随访期间2例患者因终末期心竭死亡,导致2年随访中全因死亡率达54%。在2年随访期间,除1例外所有患者均纽约心功能分级II级,并没有瓣膜故障病例(梯度增加或MR复发)。3例患者2年随访时的CT检查显示没有瓣膜假体破裂或移位。使用FORTIS瓣膜的TMVR是可行

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GetPortalCommentsPageByObjectIdResponse(id=1510084, encodeId=a8b41510084f0, content=<a href='/topic/show?id=e9bce8254ef' target=_blank style='color:#2F92EE;'>#经导管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78254, encryptionId=e9bce8254ef, topicName=经导管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=93e010191378, createdName=lsj631, createdTime=Thu Aug 24 02:51:00 CST 2017, time=2017-08-24, status=1, ipAttribution=)]
    2018-02-24 yxch48
  2. 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    2017-09-09 哈哈869

    好学了

    0

  4. 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target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Thu Aug 24 02:51:00 CST 2017, time=2017-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1463166, encodeId=587314631667d, content=<a href='/topic/show?id=cff92389310' target=_blank style='color:#2F92EE;'>#二尖瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23893, encryptionId=cff92389310, topicName=二尖瓣)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fdb26536308, createdName=wwzzly, createdTime=Thu Aug 24 02:51:00 CST 2017, time=2017-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1510084, encodeId=a8b41510084f0, content=<a href='/topic/show?id=e9bce8254ef' target=_blank style='color:#2F92EE;'>#经导管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78254, encryptionId=e9bce8254ef, topicName=经导管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=93e010191378, createdName=lsj631, createdTime=Thu Aug 24 02:51:00 CST 2017, time=2017-08-24, status=1, ipAttribution=)]
    2017-09-04 哈哈869

    学了

    0

  5. 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  6. 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target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Thu Aug 24 02:51:00 CST 2017, time=2017-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1463166, encodeId=587314631667d, content=<a href='/topic/show?id=cff92389310' target=_blank style='color:#2F92EE;'>#二尖瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23893, encryptionId=cff92389310, topicName=二尖瓣)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fdb26536308, createdName=wwzzly, createdTime=Thu Aug 24 02:51:00 CST 2017, time=2017-08-24, status=1, ipAttribution=), 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    2017-09-21 hbwxf
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target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Thu Aug 24 02:51:00 CST 2017, time=2017-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1463166, encodeId=587314631667d, content=<a href='/topic/show?id=cff92389310' target=_blank style='color:#2F92EE;'>#二尖瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23893, encryptionId=cff92389310, topicName=二尖瓣)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fdb26536308, createdName=wwzzly, createdTime=Thu Aug 24 02:51:00 CST 2017, time=2017-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1510084, encodeId=a8b41510084f0, content=<a href='/topic/show?id=e9bce8254ef' target=_blank style='color:#2F92EE;'>#经导管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78254, encryptionId=e9bce8254ef, topicName=经导管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=93e010191378, createdName=lsj631, createdTime=Thu Aug 24 02:51:00 CST 2017, time=2017-08-24, status=1, ipAttribution=)]
    2017-08-24 明天会更好!

    谢谢分享谢谢分享!

    0

  8. 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  9. 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GetPortalCommentsPageByObjectIdResponse(id=1510084, encodeId=a8b41510084f0, content=<a href='/topic/show?id=e9bce8254ef' target=_blank style='color:#2F92EE;'>#经导管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78254, encryptionId=e9bce8254ef, topicName=经导管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=93e010191378, createdName=lsj631, createdTime=Thu Aug 24 02:51:00 CST 2017, time=2017-08-24, status=1, ipAttribution=)]
    2017-08-24 wwzzly
  10. 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    2017-08-24 lsj631

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心力衰竭(心衰)是由于各种心脏结构和/或功能异常导致心室充盈和/或射血能力受损的一组复杂的临床综合征。心衰发病率高,诊断和治疗困难,在全面临床评估和分析的基础上,合理地将生物标志物应用于其诊疗可起到事半功倍的效果。目前生物标志物可用于心衰的诊断、临床评估和预后评价等方面,其中,利钠肽家族中的B型利钠肽(BNP)和N末端B型利钠肽原(NT—proBNP)应用尤其广泛,本建议旨在为基层医院医师在心衰诊

Heart:哪种药物治疗方式对保留射血分数的心力衰竭患者理想?

目前,心力衰竭和保留射血分数患者的临床药物试验尚未能证明对死亡率的改善作用。近期,一项发表在杂志Heart上的研究系统地搜索了从1996年1月至2016年5月Medline、Embase和Cochrane的对照试验中心登记册,入选评估了心力衰竭且左心室(LV)射血分数≥40%患者的药物治疗的随机对照试验(RCT)。此项研究的主要结局是全因死亡率。次要结局是心血管死亡率、心力衰竭导致的住院、运动能力

从指南到临床—再读2017ACC/AHA/HFSA心力衰竭处理指南

*2017年4月Circulation杂志在线发布由ACC/AHA/HFSA联合制定的《2017ACC/AHA/HFSA 心衰处理指南更新》,它不仅是2013ACC/AHA心衰处理指南的更新版,也是2016ACC/AHA/HFSA心衰新药物治疗更新的二期发表。自2016年指南发布以来,国内许多专家已进行解读分析。本文比较2016、2017心衰指南,归纳出用于临床的几点建议。

JAMA Cardiology:心肌纤维化和保留射血分数心力衰竭的时间关系

在发展至心力衰竭过程中保留射血分数(HFpEF)发生的万千变化中,心肌细胞细胞外基质的相互作用可能会影响微血管、机制和电功能。

Eur Heart J:年轻的心脏干细胞或能“干掉”衰老

8月14日发表在欧洲心脏杂志上一项研究表明,年轻的心肌球来源细胞可通过心脏基因表达、心脏功能、运动能力和系统生物标记物等方法恢复衰老动物的活力。我们离“干掉”衰老或许又近了一步。