Heart:经导管主动脉瓣植入患者右心室与肺动脉的联结

2018-08-10 xiangting MedSci原创

基线TAPSE/PASP比值与TAVI患者的全因死亡率相关,因为它在既定程度的后负荷下评估了RV收缩性能。

这项研究在经导管主动脉瓣置换(TAVI)患者中,评估了三尖瓣环平面收缩期位移(TAPSE)与肺动脉收缩压(PASP)的比值作为右室肺动脉(RV-PA)联结决定因素的预后价值。 

RV功能和肺动脉高压(PH)都对TAVI患者的预后有重要影响。已证明RV-PA联结对心力衰竭患者的预后有重要影响,但未在TAVI患者中进行过评估。

研究纳入2011年7月至2016年1月接受TAVI患重度主动脉瓣狭窄的连续性患者,这些患者进行了全面的基线超声心动图检查。所有个体的超声心动图图像和多普勒数据都经过独立审查,审查者对临床信息和预后不知情。调整了混杂因素后,Cox模型量化了TAPSE/PASP四分位数对全因死亡率的影响。

共纳入457例患者,平均年龄82.8±7.2岁,左心室射血分数(LVEF)为54%±13%,PASP 44±17mmHg。TAPSE/PASP四分位数与生存率存在剂量-反应关系。在调整年龄、房颤、LVEF、每搏输出量指数、胸外科医师协会预测死亡风险后,与生存率仍存在显著关联(最低四分位数vs最高四分位数的HR= 2.21,95%CI 1.07至4.57,p=0.03)。

基线TAPSE/PASP比值与TAVI患者的全因死亡率相关,因为它在既定程度的后负荷下评估了RV收缩性能。将右心室纳入风险分层可以改善TAVI患者的最佳选择。

原始出处:

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    2018-08-12 zhaojie88
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content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55683, createdName=仁医06, createdTime=Sun Aug 12 05:57:00 CST 2018, time=2018-08-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337888, encodeId=03af33e888fa, content=谢谢分享,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Sat Aug 11 10:20:41 CST 2018, time=2018-08-11, status=1, ipAttribution=)]
  5. 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content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55683, createdName=仁医06, createdTime=Sun Aug 12 05:57:00 CST 2018, time=2018-08-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337888, encodeId=03af33e888fa, content=谢谢分享,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Sat Aug 11 10:20:41 CST 2018, time=2018-08-11, status=1, ipAttribution=)]
    2018-08-12 lsj631
  6. 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content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55683, createdName=仁医06, createdTime=Sun Aug 12 05:57:00 CST 2018, time=2018-08-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337888, encodeId=03af33e888fa, content=谢谢分享,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Sat Aug 11 10:20:41 CST 2018, time=2018-08-11, status=1, ipAttribution=)]
    2018-08-12 jiyangfei
  7. 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content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55683, createdName=仁医06, createdTime=Sun Aug 12 05:57:00 CST 2018, time=2018-08-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337888, encodeId=03af33e888fa, content=谢谢分享,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Sat Aug 11 10:20:41 CST 2018, time=2018-08-11, status=1, ipAttribution=)]
  8. 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content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55683, createdName=仁医06, createdTime=Sun Aug 12 05:57:00 CST 2018, time=2018-08-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337888, encodeId=03af33e888fa, content=谢谢分享,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Sat Aug 11 10:20:41 CST 2018, time=2018-08-11, status=1, ipAttribution=)]
    2018-08-12 仁医06
  9. 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ipAttribution=)]
    2018-08-11 明月清辉

    谢谢分享,学习了

    0

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