PLos One:二尖瓣病变患者瓣膜手术后身体成分的变化

2018-09-24 xiangting MedSci原创

在严重MV病的患者中,矫正性MV手术对消瘦过程和血液动力学改善均存在有利影响。

慢性心衰患者的身体成分有所改变,表现为脂肪量、瘦体重和骨质量降低。然而,瓣膜心脏病中的身体消瘦和矫正性瓣膜手术对身体成分的影响尚未得到研究。这项研究假设严重二尖瓣病(MV)的身体消瘦通过MV手术是可逆的。

连续性纳入48名计划接受MV手术的患者,排除合并性瓣膜心脏病、缺血性心脏病、心肌病和正在服用可能影响代谢的药物的患者。在MV手术前和手术后1年,所有患者均接受食欲简化营养评估问卷(SNAQ)、实验室检查、超声心动图和双能X线吸收仪(DXA)检查。

MV手术后1年,患者的食欲增加,实验室检查数据和血液动力学均有改善。当研究人员根据原发MV病变对患者进行分类时,二尖瓣返流(MR)和二尖瓣狭窄(MS)患者的体重均没有变化。然而,在MR患者中观察到骨矿物质密度和体脂百分比显著增加,而在MS患者中未观察到这种情况。在MR患者中,Δfat≥2%的患者术前估算右心室收缩压(eRVSP)水平和术后eRVSP降幅显著大于Δfat<2%的患者,ΔSNAQ和Δfat均与ΔeRVSP呈显著负相关。

在严重MV病的患者中,矫正性MV手术对消瘦过程和血液动力学改善均存在有利影响。特别是,右室压力超负荷与MR患者的食欲和体脂百分比的变化密切相关。

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    2018-09-26 wwzzly
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