JACC:二叶主动脉瓣(BAV)病和主动脉病之间有什么联系?

2016-04-12 崔倩 译 MedSci原创

二叶主动脉瓣(BAV)病和主动脉病之间的关联还没有被完全定义。本研究旨在前瞻性分析在接受手术治疗BAV vs 三尖瓣(TAV)狭窄的患者中,主动脉根部的功能参数和主动脉病变之间的相关性。从2012年1月1日至2014年12月31日,连续190例患者(63±8岁,67%为男性)接受了主动脉瓣置换±近端主动脉手术治疗BAV狭窄(n=137,BAV组)和TAV狭窄(n=53,TAV组)。所有患者接受术前

二叶主动脉瓣(BAV)病和主动脉病之间的关联还没有被完全定义。

本研究旨在前瞻性分析在接受手术治疗的BAV vs 三尖瓣(TAV)狭窄的患者中,主动脉根部的功能参数和主动脉病变之间的相关性。

从2012年1月1日至2014年12月31日,连续190例患者(63±8岁,67%为男性)接受了主动脉瓣置换±近端主动脉手术治疗BAV狭窄(n=137,BAV组)和TAV狭窄(n=53,TAV组)。所有患者接受术前心脏磁共振成像评估主动脉根部形态学/功能参数。基于主动脉壁偏心血流接触的位置,主动脉组织样本在手术过程中获取,由心脏磁共振(即,试验样本和对照样本)确定。主动脉壁病变用组织学总和评分(0〜21)进行分级。

两组的最大横截面主动脉直径均在中期上升水平,在BAV组的患者偏大(分别为40.2±7.2 mm vs 36.6±3.3mm,P<0.001)。组织学总和得分BAV组为2.9±1.4,TAV组为3.4±2.6(P=0.4)。两组的最大编入索引的主动脉直径和左心室流出轴和主动脉根部(左心室/主动脉夹角)之间的角度呈线性相关(BAV组: r=0.6, p<0.001 vs TAV组 r=0.45, p=0.03, z=1.26, p=0.2)。Logistic回归确定左心室/主动脉夹角可作为编入索引的主动脉直径>22mm/m2的指示因子(比值比:1.2;P<0.001)。

在BAV和TAVR狭窄的患者中,研究人员发现在功能性主动脉根部参数和主动脉病变之间有可比较的相关模式。

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    2016-05-29 hbwxf
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    2016-04-14 李继凯

    高大上的文章

    0

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    2016-04-14 李继凯

    值得学习

    0

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NEJM:二叶主动脉瓣临床综述

二叶主动脉瓣(BAV)是成人先天性心脏病中最常见的类型之一,发生率约为1.3%。相比其他先天性心脏病其致死率和并发症发生率较高。虽然主动脉瓣狭窄和反流是BAV最常见的并发症,然而主动脉根至主动脉弓近端的任何或所有部位的扩张在这些患者中大约占50%。现有证据显示BAV患者主动脉扩张的形式多变,这可能表明在分子机制、血液流变学及临床特征方面存在异质性。鉴于此,来自加拿大多伦多大学圣米高医院心脏外科