摘要
目的:探讨重度主动脉瓣狭窄(AS)患者行经导管主动脉瓣置换术(TAVR)后,超声心动图参数及功能性二尖瓣反流(FMR)的转归情况,以及影响FMR预后的相关因素。方法:回顾性分析2017年6月至2020年7月,首都医科大学附属北京安贞医院收治的142例接受TAVR治疗的重度AS合并FMR患者,分析基线信息,比较手术前后超声心动图参数及FMR的转归,通过Logistic回归分析影响FMR转归的因素。结果:TAVR术后FMR中62.7%的患者二尖瓣反流较术前改善。超声心动检查中LAD、室间隔厚度(ⅣS)、主动脉瓣上流速(Vmax)、主动脉瓣最大压差(Peak-AVG)、LVEDD、LVESD、左室后壁厚度(LVPW)、主动脉窦部、肺动脉压力、肺动脉最大流速均较术前有明显改善(P<0.05),而LVEF、升主动脉内径较术前无改变。Logistic回归分析显示LAD、LVPW、Vmax、二尖瓣术前反流分级、术前合并冠心病为影响FMR改善的预测因素。结论:TAVR治疗可改善重度AS合并FMR患者的二尖瓣反流,而LAD、LVPW、Vmax、二尖瓣术前反流分级、术前合并冠心病是影响TAVR术后FMR转归的危险因素。
Objective:To investigate the echocardiographic parameters and the outcome of functional mitral regurgitation(FMR)after transcatheter aortic valve replacement(TAVR)in patients with severe aortic stenosis(AS),as well as the related factors affecting the prognosis of FMR.Methods:A total of 142 patients with severe AS complicated with FMR who received TAVR in Beijing Anzhen Hospital,Capital Medical University from June 2017 to July 2020 were retrospectively analyzed.The baseline information was analyzed.The echocardiographic parameters before and after operation and the outcome of FMR were compared.The factors affecting the outcome of FMR were analyzed by logistic regression.Results:FMR after TAVR improved in 62.7%of patients.In echocardiography,LAD,interventricular septum thickness(ⅣS),Maximum velocity on aortic valve(Vmax),peak aortic valve pressure gradient(Peak-AVG),LVEDD,LVESD,left ventricular posterior wall thickness(LVPW),aortic sinus,pulmonary arterial pressure and maximum pulmonary arterial velocity were significantly improved(P<0.05),while LVEF and ascending aorta diameter were not changed.Logistic regression analysis showed that LAD,LVPW,Vmax,mitral valve grade and preoperative coronary heart disease were predictors of FMR improvement.Conclusions:s TAVR can improve the mitral valve in patients with severe AS complicated with FMR.LAD,LVPW,Vmax,mitral valve grade and preoperative coronary heart disease are risk factors affecting the outcome of FMR after TAVR.
作者
李艳丽
刘巍
韩玮
周玉杰
于一
贾硕
张海波
王胜洵
兰永昊
高亚楠
娄亚柯
LI Yanli;LAN Yonghao;HAN Wei;GAO Yanan;LOU Yake;YU Yi;JIA Shuo;ZHANG Haibo;WANG Shengxun;ZHOU Yujie;LIU WEI(Department of Geriatrics,People’s Hospital of Inner Mongolia Medical University,Hohhot 010010,China)
出处
《心肺血管病杂志》
CAS
2021年第2期130-134,共5页
Journal of Cardiovascular and Pulmonary Diseases
