Heart：TAVR可改善不能手术的严重主动脉狭窄患者生存

2015-01-30 小田译医学论坛网

美国学者探讨了在经导管主动脉瓣置换(TAVR)和标准治疗严重主动脉狭窄(AS)患者中，患者的左心室功能异常对其临床转归的影响，评估了左心室射血分数(LVEF)及其对随后临床转归的影响。结果表明，在不能手术治疗的严重AS患者中，经标准治疗患者的轻至中度左心室功能异常与心脏死亡率更高有相关性，而接受TAVR治疗则无此相关性。研究者指出，TAVR可改善生存并应作为不能手术治疗且LVEF>20%

美国学者探讨了在经导管主动脉瓣置换(TAVR)和标准治疗严重主动脉狭窄(AS)患者中，患者的左心室功能异常对其临床转归的影响，评估了左心室射血分数(LVEF)及其对随后临床转归的影响。结果表明，在不能手术治疗的严重AS患者中，经标准治疗患者的轻至中度左心室功能异常与心脏死亡率更高有相关性，而接受TAVR治疗则无此相关性。研究者指出，TAVR可改善生存并应作为不能手术治疗且LVEF>20%患者的标准治疗方法。

研究者纳入了不能手术治疗的严重AS患者342例，并让其接受标准治疗或TAVR治疗。以LVEF<50%定义为左心室功能异常，以在30天内LVEF绝对增加≥10%定义为LVEF改善。

结果显示，基线左心室功能异常并不影响TAVR治疗后的生存，但却与标准治疗后1年心脏死亡率增加有相关性(与LVEF正常者相比，HR=1.71，P=0.02)。在那些左心室功能异常者相比，TAVR和标准治疗组分别有48.7%和30.4%的患者LVEF有所改善(P=0.08)，且独立于相对室壁厚度和TAVR治疗的预测。其中，一部分经标准治疗的左心室功能异常患者的LVEF有所改善，第1年时全因死亡也有所减少，但并不改善第2年的生存率。

原始出处：

Passeri JJ1, Elmariah S2, Xu K3, Inglessis I1, Baker JN4, Alu M3, Kodali S3, Leon MB3, Svensson LG5, Pibarot P6, Fearon WF7, Kirtane AJ3, Vlahakes GJ4, Palacios IF1, Douglas PS8; on behalf of the PARTNER Investigators.Transcatheter aortic valve replacement and standard therapy in inoperable patients with aortic stenosis and low EF.Heart. 2015 Jan 13. pii: heartjnl-2014-306737. doi: 10.1136/heartjnl-2014-306737. [Epub ahead of print]

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2015-08-18 wangtianj2007@

#AVR#

23 0
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2015-11-04 tastas

#患者生存#

24 0
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2015-02-17 chinayinhan

已阅

125 0
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2015-02-01 longerg

#主动脉狭窄#

25 0
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2015-02-01 zhaojie88

#ART#

20 0
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2015-02-01 circumcision

#主动脉#

28 0
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2015-02-01 piaojinhua

#动脉狭窄#

25 0
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2015-02-01 爆笑小医

#HEART#

23 0

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