Heart：主动脉瓣狭窄进展过程中每搏输出量对心血管风险有何影响？

2017-04-29 xing.T MedSci原创

由此可见，在SEAS研究的AS患者中，较低的基础SVI与较高的主要心血管事件和总死亡率风险比相关，并且独立于主要的混杂因素。

在严重的主动脉瓣狭窄（AS）患者中，低左心室（LV）每搏输出量与心血管疾病（CV）的死亡率增加相关，但在大型的前瞻性研究中，AS进展期间这种相关性还没有被深入的进行探究。近日，在心脏病领域权威杂志Heart上针对这一问题发表了一篇研究文章。

在1671例来自于辛伐他汀联合依折麦布治疗主动脉瓣狭窄（SEAS）研究的患者中，研究人员经过4.3年的随访后通过Cox和随时间变化的Cox回归分析评估了经体表面积指数化的每搏输出量（SVI）与主要心血管事件之间的相关性。低SVI被定义为小于35 毫升/平方米。

在总体研究人群中主动脉射流速度峰值为3.1±0.7米/秒，在基线时发现低SVI患者占23%，与较高的年龄、体重指数（BMI）、心率、左心室总负荷以及较低的平均主动脉梯度、主动脉瓣面积指数、能量损失指数、左心室质量和射血分数与AS分级不一致相关（所有P＜0.05）。基础SVI降低5毫升/平方米与更高的主要心血管事件（n=544）（风险比为1.09，95%可信区间为1.05-1.13，P＜0.001）和总死亡率（n=147）（风险比为1.08，95%可信区间为1.01-1.16，P=0.038）的风险比相关，并且独立于年龄、性别、房颤、主动脉平均梯度、左心室射血分数、左心室质量、BMI以及研究治疗。调整了相同的变量，低基础SVI和研究期间低SVI均与主要心血管事件的发生率增加相关。

由此可见，在SEAS研究的AS患者中，较低的基础SVI与较高的主要心血管事件和总死亡率风险比相关，并且独立于主要的混杂因素。

原始出处：

Mai Tone Lønnebakken,et al. Impact of stroke volume on cardiovascular risk during progression of aortic valve stenosis. Heart. 2017.http://dx.doi.org/10.1136/heartjnl-2016-310917

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2018-02-26 ms5353107019656438

#血管风险#

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2017-05-01 hittouch

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2017-05-01 zhaojie88

#ART#

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Apr 29 17:24:27 CST 2017, time=2017-04-29, status=1, ipAttribution=)]
2017-05-01 circumcision

#主动脉#

23 0
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2017-05-01 slcumt

#HEART#

22 0
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2017-04-30 solarjin

心衰和心梗的联系

67 0
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Apr 29 17:24:27 CST 2017, time=2017-04-29, status=1, ipAttribution=)]
2017-04-30 tanxingdoctor

学习了谢谢分享

62 0
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2017-04-29 圣艮山

心内科的研究还是好

50 0
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2017-04-29 jin321

学习

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