The impact of ventricular remodeling and myocardial function of transcatheter aortic valve replacement for elderly patients with severe aortic stenosis
The impact of ventricular remodeling and myocardial function of transcatheter aortic valve replacement for elderly patients with severe aortic stenosis
尹浡 1张宇 1张华 1厉菁1
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作者信息
1. 450000 郑州市第七人民医院心内科
折叠
摘要
目的:分析经导管主动瓣置换术(surgical aortic valve replacement,TAVR)治疗老年重度主动脉瓣狭窄(aortic stenosis,AS)患者的临床疗效及对心室重构、心肌功能的影响.方法:收集2019年1月至2021年12月行TAVR术治疗重度AS患者48例临床资料,分析手术前后心室重构指标[LVEF、LVEDD、平均主动脉瓣跨瓣压差(mean transvalvular pressure gradient,MPG),主动脉瓣峰值流速(maximum velocity,Vmax)、左心室质量指数(left ventricular mass index,LVMI)]、心肌功能指标[左室整体做功指数(global work index,GWI)、整体有用功(global constructive work,GCW)、整体无用功(global waste work,GWW)、整体做功效率(global work efficiency,GWE)]、以及术后终点事件.结果:术后1周,老年重度AS手术患者MPG、Vmax低于术前(P＜0.05);术后 1、6 及 12个月,LVEV高于术前(P＜0.05),LVEDD、MPG、Vmax、LVMI 均低于术前(P＜0.05).术后1、6及12个月,GWI、GCW、GWE均高于术前(P＜0.05),GWW低于术前(P＜0.05).随访12个月,全因死亡1例(2.1％),脑卒中3例(6.3％),心肌梗死4例(8.3％),大出血3例(6.3％),新发传导阻滞12例(25.0％),瓣周漏7例(14.6％),永久起搏器植入9例(18.8％).结论:TAVR术能够矫正老年重度AS患者心室重构,改善心肌功能,且有良好的安全性及有效性.
Abstract
Objective:The clinical effects,ventricular remodeling and myocardial function of TAVR in treatment of elderly patients with severe AS were analyzed.Methods:The clinical data of 48 patients with severe AS who underwent TAVR from January 2019 to December 2021 were collected,then Left ventricular remodeling(LVEF,LVEDD,MPG,Vmax,LVMI),myocardial function(GWI,GCW,GWW,GWE)before and after operation,and postoperative end points were analyzed.Results:One week after operation,elderly patients with severe AS MPG,Vmax lower than before operation(P＜0.05);1 month,6 months,12 months after operation,LVEV higher than before operation(P＜0.05),LVEDD,MPG,Vmax,LVMI lower than before operation(P＜0.05).1 month,6 months,12 months after operation,GWI,GCW,GWE higher than before operation(P＜0.05),GWW lower than before operation(P＜0.05).Twelve-months follow-up,all-cause mortality 1 cases(2.1％),stroke 3 cases(6.3％),myocardial infarction 4 cases(8.3％),massive hemorrhage 3 cases(6.3％),New-onset conduction block 12 cases(25.0％),perivalvular leakage 7 cases(14.6％),permanent pacemaker implantation 9 cases(18.8％).Conclusion:TAVR can correct ventricular remodeling and improve myocardial function in elderly patients with severe AS and has good security and the validity.
关键词
老年/重度主动脉瓣狭窄/经导管主动脉瓣置换术/心室重构/心肌功能
Key words
Elderly/Severe aortic stenosis/Transcatheter aortic valve replacement/Ventricular remodeling/Myocardial function
维普
万方数据