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Heart：单一AS和AVA小于1cm2患者的临床特点及预后分析！

2017-08-17 xing.T MedSci原创

ASAVA临床特点预后
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由此可见，AVA为0.8-0.99cm2的患者结局是可变的，需要根据流量-压力梯度状态更精确地进行定义。该研究的结果支持当前的将AVA的临界值定为1.0cm2。

目前的指南将重度主动脉瓣狭窄（AS）定义为主动脉瓣区（AVA）≤1.0cm2，但一些学者认为AVA的临界值应减少到0.8cm2。近日，在心脏病领域权威杂志Heart上发表了一篇研究文章，研究人员旨在更好地描述AVA为0.8-0.99cm2患者的预后和临床特点。

研究人员将单一的、严重的并且射血分数≥55%AVA为0.8-0.99cm2的患者（n=105）与那些与AVA＜0.8cm2（n=155）和1.0-1.3cm2（n=81）的患者进行比较。这项研究的终点是3年任何原因额的死亡或主动脉瓣置换。

研究人员发现AVA为0.8-0.99cm2的患者主要表现为正常流量、低压力梯度（NFLG）AS，而在AVA＜0.8cm2的患者中经常观察到高压力梯度和低流量。在AVA为0.8-0.99cm2和1.0-1.3cm2患者之间的症状频率没有显著差异。在AVA为＜0.8cm2、0.8-0.99cm2和1.0-1.3cm2的患者中联合终点分别达到71%、52%和21%（P＜0.001）。在AVA为0.8-0.99cm2的患者中，NFLG AS与较低的联合终点风险相关（HR为0.40，95%CI为0.23-0.68，P=0.001），并且在前1.5年随访期间与中度AS的结局相类似。AVA临界值为0.8cm2时，联合终点的灵敏度为61%；AVA的临界值为1.0cm2时，联合终点的灵敏度为91%。

由此可见，AVA为0.8-0.99cm2的患者结局是可变的，需要根据流量-压力梯度状态更精确地进行定义。该研究的结果支持当前的将AVA的临界值定为1.0cm2。

原始出处：

Praveen Mehrotra,et al. Clinical features and prognosis of patients with isolated severe aortic stenosis and valve area less than 1.0 cm2. Heart. 2017. http://dx.doi.org/10.1136/heartjnl-2016-310729

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    2018-03-16 feather78

    #临床特点#

    0

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    2017-08-22 情途末路

    学习了.获益匪浅!感谢分享

    0

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    2017-08-21 1e145228m78(暂无匿称)

    学习了.谢谢作者分享!

    0

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    2017-08-21 大爰

    学习了谢谢分享！！

    0

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    2017-08-19 1e145228m78(暂无匿称)

    学习了谢谢作者分享!

    0

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    2017-08-19 zhaojie88

    #ART#

    0

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    2017-08-19 slcumt

    #HEART#

    0

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    2017-08-18 大爰

    学习了谢谢分享！！

    0

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    2017-08-17 1e145228m78(暂无匿称)

    学习了，谢谢作者分享!

    0

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