SCI REP:梗阻性肥厚型心肌病患者室间隔酒精消融术后并发症和长期结局如何?

2017-08-28 xing.T MedSci原创

总之,在ASA的围手术期死亡率和并发症是较为罕见的。ASA后长期生存率相比于NOHCM患者较为满意。40岁以下患者接受ASA治疗应更加谨慎,这些患者更容易在ASA围手术期耐受致命性室性心律失常。

室间隔酒精消融(ASA)术后并发症和长期生存率数据在中国梗阻性肥厚型心肌病(HOCM)患者中仍是缺乏的。近日,Scientific reports 杂志上发表了一篇研究文章,研究人员的目的是探讨HOCM患者接受ASA后长期生存率,并与非梗阻性肥厚型心肌病(NOHCM)患者进行比较。

该研究共招募了233例HOCM并且静息时峰值压力梯度≥50 mmHg的患者,这些患者在2000年至2012年期间连续就诊于中国阜外医院。另外,有297例无左室流出道梗阻者作为对照者。

研究人员发现ASA的围手术期死亡率较低(0.89%)。9例患者(4%)发生了围手术期致命性室性心律失常。酒精用量(RR为1.44,95%CI为1.03-2.03,P=0.034)和年龄小于40岁(RR为4.63,95%CI为1.07-20,P=0.040)是围手术期致死性室性心律失常的独立预测因子。ASA患者10年总生存率为94.6%,与NOHCM组患者的92.9%相似(P=0.930)。

总之,在ASA的围手术期死亡率和并发症是较为罕见的。ASA后长期生存率相比于NOHCM患者较为满意。40岁以下患者接受ASA治疗应更加谨慎,这些患者更容易在ASA围手术期耐受致命性室性心律失常。

原始出处:

Shuo-yan An,et al. Procedural complication and long term outcomes after alcohol septal ablation in patients with obstructive hypertrophic cardiomyopathy: data from China.Scientific reports. 2017. https://www.nature.com/articles/s41598-017-10144-0

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    2017-12-28 丁鹏鹏
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