JACC:一种预测经导管二尖瓣置换术前左心室流出道梗阻的新型多相评估法

2019-12-05 xiangting MedSci原创

与收缩末期评估相比,新LVOT的多相尤其是收缩早期评估可以更好地确定经导管二尖瓣置换术的LVOTO风险。

这项研究提出了一种生理学评估左心室流出道梗阻(LVOTO)的方法,可以适应收缩血流的变化并考虑到动态的新左心室流出道(LVOT)。

计划进行经导管二尖瓣置换的患者通常由于被认为存在LVOTO风险而筛查失败。在无畏全球试点研究中,假定的LVOTO风险是基于对收缩末期新LVOT区域的CT估算。但这可能高估了实际风险。

对因潜在LVOTO筛查失败的患者(n=33)和有可用动态CT的治疗患者(n=29)进行回顾性分析。对新LVOT区域进行了多相评估,并表示为:1)多阶段平均值;2)早期收缩值。对9名既往使用收缩末期法筛查失败的患者进行了前瞻性评估,这些患者被纳入多相和早期收缩法。

166名患者进行了筛查;其中32名患者由于非解剖学原因筛查失败。134名患者中有37名(27.6%)因假定的LVOTO风险筛查失败。回顾性分析表明使用多相和早期收缩评估法,潜在的入组人数分别增加11/3333.3%)和18/3354.5%)。在前瞻性队列中,尽管存在基于收缩末期估算的风险,术后30天未观察到临床LVOTO

与收缩末期评估相比,新LVOT的多相尤其是收缩早期评估可以更好地确定经导管二尖瓣置换术的LVOTO风险。这种新型方法显著提高了患者的入组率,超过一半的既往筛查失败患者现在可以接受治疗。

原始出处:

Christopher U. Meduri. Novel Multiphase Assessment for Predicting Left Ventricular Outflow Tract Obstruction Before Transcatheter Mitral Valve Replacement. JACCCardiovascular Interventions. December 2019.

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    2020-09-13 hbwxf
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createdName=lqrandywkz, createdTime=Sun Jul 05 16:36:00 CST 2020, time=2020-07-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1952636, encodeId=894f195263652, content=<a href='/topic/show?id=7366e827955' target=_blank style='color:#2F92EE;'>#经导管二尖瓣置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78279, encryptionId=7366e827955, topicName=经导管二尖瓣置换术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7ca4300, createdName=wodejia-dayu, createdTime=Fri Dec 27 22:36:00 CST 2019, time=2019-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1742650, encodeId=5f181e426501a, content=<a href='/topic/show?id=39cae96626f' target=_blank style='color:#2F92EE;'>#置换#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79662, 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href='/topic/show?id=e9bce8254ef' target=_blank style='color:#2F92EE;'>#经导管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78254, encryptionId=e9bce8254ef, topicName=经导管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=93e010191378, createdName=lsj631, createdTime=Sat Dec 07 03:36:00 CST 2019, time=2019-12-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1576743, encodeId=fff315e6743b8, content=<a href='/topic/show?id=48fee966468' target=_blank style='color:#2F92EE;'>#置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79664, encryptionId=48fee966468, topicName=置换术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=054816326830, createdName=ms117281293605716, createdTime=Sat Dec 07 03:36:00 CST 2019, time=2019-12-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=376574, encodeId=31533e6574dd, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Thu Dec 05 12:52:57 CST 2019, time=2019-12-05, status=1, ipAttribution=)]
    2020-04-03 yxch48
  5. 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time=2019-12-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=376574, encodeId=31533e6574dd, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Thu Dec 05 12:52:57 CST 2019, time=2019-12-05, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1854602, encodeId=8e1f18546023f, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Sun Sep 13 19:36:00 CST 2020, time=2020-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1982475, encodeId=d64d19824e5f9, content=<a href='/topic/show?id=4446239166f' target=_blank style='color:#2F92EE;'>#二尖瓣置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23916, encryptionId=4446239166f, topicName=二尖瓣置换术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=86b7385, 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  7. 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channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48033, encryptionId=1d7e48033f5, topicName=左心室)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=15012955474, createdName=wushaoling, createdTime=Sat Dec 07 03:36:00 CST 2019, time=2019-12-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1463271, encodeId=c64114632e162, content=<a href='/topic/show?id=cff92389310' target=_blank style='color:#2F92EE;'>#二尖瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23893, encryptionId=cff92389310, topicName=二尖瓣)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fdb26536308, createdName=wwzzly, createdTime=Sat Dec 07 03:36:00 CST 2019, time=2019-12-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1510257, encodeId=79eb151025ed6, content=<a href='/topic/show?id=e9bce8254ef' target=_blank style='color:#2F92EE;'>#经导管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78254, encryptionId=e9bce8254ef, topicName=经导管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=93e010191378, createdName=lsj631, createdTime=Sat Dec 07 03:36:00 CST 2019, time=2019-12-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1576743, encodeId=fff315e6743b8, content=<a href='/topic/show?id=48fee966468' target=_blank style='color:#2F92EE;'>#置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79664, encryptionId=48fee966468, topicName=置换术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=054816326830, createdName=ms117281293605716, createdTime=Sat Dec 07 03:36:00 CST 2019, time=2019-12-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=376574, encodeId=31533e6574dd, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Thu Dec 05 12:52:57 CST 2019, time=2019-12-05, status=1, ipAttribution=)]
    2019-12-07 wwzzly
  8. [GetPortalCommentsPageByObjectIdResponse(id=1854602, encodeId=8e1f18546023f, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Sun Sep 13 19:36:00 CST 2020, time=2020-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1982475, encodeId=d64d19824e5f9, content=<a href='/topic/show?id=4446239166f' target=_blank style='color:#2F92EE;'>#二尖瓣置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23916, encryptionId=4446239166f, topicName=二尖瓣置换术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=86b7385, 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encryptionId=39cae96626f, topicName=置换)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3a7c35056336, createdName=yxch48, createdTime=Fri Apr 03 12:36:00 CST 2020, time=2020-04-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1326429, encodeId=e3041326429c5, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Sat Dec 07 03:36:00 CST 2019, time=2019-12-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1413271, encodeId=203e14132e1e7, content=<a href='/topic/show?id=1d7e48033f5' target=_blank style='color:#2F92EE;'>#左心室#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48033, encryptionId=1d7e48033f5, topicName=左心室)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=15012955474, createdName=wushaoling, createdTime=Sat Dec 07 03:36:00 CST 2019, time=2019-12-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1463271, encodeId=c64114632e162, content=<a href='/topic/show?id=cff92389310' target=_blank style='color:#2F92EE;'>#二尖瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23893, encryptionId=cff92389310, topicName=二尖瓣)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fdb26536308, createdName=wwzzly, createdTime=Sat Dec 07 03:36:00 CST 2019, time=2019-12-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1510257, encodeId=79eb151025ed6, content=<a href='/topic/show?id=e9bce8254ef' target=_blank style='color:#2F92EE;'>#经导管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78254, encryptionId=e9bce8254ef, topicName=经导管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=93e010191378, createdName=lsj631, createdTime=Sat Dec 07 03:36:00 CST 2019, time=2019-12-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1576743, encodeId=fff315e6743b8, content=<a href='/topic/show?id=48fee966468' target=_blank style='color:#2F92EE;'>#置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79664, encryptionId=48fee966468, topicName=置换术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=054816326830, createdName=ms117281293605716, createdTime=Sat Dec 07 03:36:00 CST 2019, time=2019-12-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=376574, encodeId=31533e6574dd, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Thu Dec 05 12:52:57 CST 2019, time=2019-12-05, status=1, ipAttribution=)]
    2019-12-07 lsj631
  9. [GetPortalCommentsPageByObjectIdResponse(id=1854602, encodeId=8e1f18546023f, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Sun Sep 13 19:36:00 CST 2020, time=2020-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1982475, encodeId=d64d19824e5f9, content=<a href='/topic/show?id=4446239166f' target=_blank style='color:#2F92EE;'>#二尖瓣置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23916, encryptionId=4446239166f, topicName=二尖瓣置换术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=86b7385, 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encryptionId=39cae96626f, topicName=置换)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3a7c35056336, createdName=yxch48, createdTime=Fri Apr 03 12:36:00 CST 2020, time=2020-04-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1326429, encodeId=e3041326429c5, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Sat Dec 07 03:36:00 CST 2019, time=2019-12-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1413271, encodeId=203e14132e1e7, content=<a href='/topic/show?id=1d7e48033f5' target=_blank style='color:#2F92EE;'>#左心室#</a>, beContent=null, objectType=article, 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time=2019-12-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=376574, encodeId=31533e6574dd, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Thu Dec 05 12:52:57 CST 2019, time=2019-12-05, status=1, ipAttribution=)]
  10. 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time=2019-12-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=376574, encodeId=31533e6574dd, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Thu Dec 05 12:52:57 CST 2019, time=2019-12-05, status=1, ipAttribution=)]
    2019-12-05 一个字-牛

    学习了谢谢分享

    0