Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques最新文献

英文中文

What Is the Significance of Greater Global Wasted Work in Patients With Apical Hypertrophic Cardiomyopathy and Apical Aneurysm? Is It the Chicken or the Egg? 心尖肥厚型心肌病和心尖动脉瘤患者的全球浪费工作量增加有何意义？是鸡还是蛋？

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques

Pub Date : 2024-10-20 DOI: 10.1111/echo.70010

Charles Pollick

引用次数: 0

Evolution and Prognostic Impact of Left Ventricular Myocardial Work Indices After Transcatheter Aortic Valve Replacement in Patients With Severe Aortic Stenosis 重度主动脉瓣狭窄患者经导管主动脉瓣置换术后左心室心肌工作指数的变化和预后影响

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques

Pub Date : 2024-10-20 DOI: 10.1111/echo.70006

Hoi W. Wu, Federico Fortuni, Tamilla Muzafarova, Camille Sarrazyn, Pilar Lopez Santi, Aileen P. A. Chua, Steele C. Butcher, Frank van der Kley, Arend de Weger, J. Wouter Jukema, Jeroen J. Bax, Nina Ajmone Marsan

Purpose

Left ventricular myocardial work (LVMW) has been shown to better characterize LV function in patients with severe aortic stenosis by correcting LV afterload. The aim of this study was to evaluate the evolution in LVMW indices after transcatheter aortic valve replacement (TAVR) and their prognostic value.

Methods

The following LVMW indices were calculated before and immediately after TAVR in 255 patients (median age 82 years, 51% male): global work index (GWI), global constructive work (GCW), global wasted work (GWW) and global work efficiency (GWE). The study endpoint was all-cause mortality.

Results

After TAVR, LV ejection fraction and LV global longitudinal strain (GLS) did not change significantly (from 56% to 55%, p = 0.470 and from 13.6% to 13.2%, p = 0.068). Concerning LVMW indices, while LV GWW remained unchanged after TAVR (from 247 to 258 mmHg%, p = 0.080), LV GWI, LV GCW, and LV GWE significantly decreased (from 1882 to 1291 mmHg%, p < 0.001, from 2248 to 1671 mmHg%, p < 0.001, and from 89% to 85%, p < 0.001, respectively). During a median follow-up of 59 [40–72] months, 129 patients died. After correcting for potential confounders (sex, diabetes, renal function, atrial fibrillation, Charlson comorbidity index, and pacemaker implantation post-TAVR), post-TAVR LV GLS, GWI, and GCW remained independently associated with all-cause mortality. However, post-TAVR LV GWI demonstrated the highest increase in model predictivity.

Conclusion

In patients undergoing TAVR, LVMW parameters significantly change after intervention. LV GWI after TAVR showed the strongest association with all-cause mortality among both conventional and advanced parameters of LV systolic function both pre- and post-TAVR and might enable better risk stratification of these patients after intervention.

目的左心室心肌功（LVMW）通过纠正左心室后负荷，已被证明能更好地描述重度主动脉瓣狭窄患者的左心室功能。本研究旨在评估经导管主动脉瓣置换术（TAVR）后 LVMW 指数的变化及其预后价值。方法计算了 255 名患者（中位年龄 82 岁，51% 为男性）在经导管主动脉瓣置换术前和术后的 LVMW 指数：全局工作指数 (GWI)、全局建设性工作 (GCW)、全局浪费工作 (GWW) 和全局工作效率 (GWE)。研究终点为全因死亡率。结果 TAVR术后，左心室射血分数和左心室整体纵向应变（GLS）无明显变化（从56%降至55%，P = 0.470；从13.6%降至13.2%，P = 0.068）。关于 LVMW 指数，虽然 TAVR 后 LV GWW 保持不变（从 247 mmHg% 到 258 mmHg%，p = 0.080），但 LV GWI、LV GCW 和 LV GWE 显著下降（分别从 1882 mmHg% 到 1291 mmHg%，p <0.001；从 2248 mmHg% 到 1671 mmHg%，p <0.001；从 89% 到 85%，p <0.001）。中位随访时间为 59 [40-72] 个月，129 名患者死亡。在校正了潜在的混杂因素（性别、糖尿病、肾功能、心房颤动、Charlson合并症指数和TAVR后植入起搏器）后，TAVR后左心室GLS、GWI和GCW仍与全因死亡率独立相关。但是，TAVR 后左心室 GWI 在模型预测中的增幅最大。结论在接受 TAVR 的患者中，介入治疗后 LVMW 参数会发生显著变化。在TAVR前后左心室收缩功能的常规参数和高级参数中，TAVR后左心室GWI与全因死亡率的相关性最强，可能有助于在介入治疗后对这些患者进行更好的风险分层。

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引用次数: 0

Assessment of the Right Ventricle Function in Patients With Significant Tricuspid Regurgitation: A Review 评估三尖瓣严重反流患者的右心室功能：综述

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques

Pub Date : 2024-10-20 DOI: 10.1111/echo.15933

Corentin Bourg, Tristan Raoult, Sabina Istratoiae, Jérémy Beaumont, Erwan Donal

Tricuspid regurgitation (TR) is an increasingly prevalent condition, especially in older populations, and presents significant challenges due to its association with right heart failure, hospital admissions, and high mortality rates. The management of TR has evolved, with new percutaneous valve repair and replacement techniques emerging alongside traditional surgical approaches. However, accurately assessing right ventricular (RV) function–a key prognostic factor in TR–remains difficult due to the RV's unique anatomy and sensitivity to loading conditions. Current echocardiographic methods, such as Tricuspid Annular Plane Systolic Excursion (TAPSE), S' wave analysis, and RV fractional area change (FAC), offer valuable insights but have limitations, particularly regarding load dependence and incomplete assessment of RV function. Advances in 3D echocardiography and myocardial strain imaging provide more comprehensive evaluations, yet challenges persist in integrating these measures in routine clinical practice. The review highlights the importance of a multimodal approach to RV assessment in TR patients, considering both the right atrium and pulmonary artery interactions, and explores potential future tools such as myocardial work and dynamic testing to improve prognostic accuracy and patient outcomes.

三尖瓣反流（TR）是一种发病率越来越高的疾病，尤其是在老年人群中，由于它与右心衰竭、住院和高死亡率有关，因此带来了巨大的挑战。随着经皮瓣膜修复和置换新技术与传统手术方法的并存，TR 的治疗方法也在不断发展。然而，由于右心室独特的解剖结构和对负荷条件的敏感性，准确评估右心室（RV）功能--TR 的关键预后因素--仍然十分困难。目前的超声心动图方法，如三尖瓣环面收缩期激惹（TAPSE）、S 波分析和 RV 面积分数变化（FAC），提供了有价值的见解，但也存在局限性，尤其是在负荷依赖性和 RV 功能评估不全面方面。三维超声心动图和心肌应变成像技术的进步提供了更全面的评估，但将这些测量方法整合到常规临床实践中仍面临挑战。这篇综述强调了采用多模态方法评估 TR 患者 RV 的重要性，同时考虑了右心房和肺动脉的相互作用，并探讨了心肌工作和动态检测等潜在的未来工具，以提高预后准确性和患者预后。

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引用次数: 0

Echocardiography of the Right Ventricle for Outcome Prediction in Heart Failure 右心室超声心动图预测心力衰竭患者的预后

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques

Pub Date : 2024-10-18 DOI: 10.1111/echo.70008

Robert Naeije

引用次数: 0

High Risk PFO-Associated Stroke: Proposed Algorithm for Better Risk Stratification 高风险 PFO 相关中风：更好地进行风险分层的拟议算法

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques

Pub Date : 2024-10-18 DOI: 10.1111/echo.70004

Petronela Cristina Chiriac, Anca Dumitrescu Bordianu, Mariana Floria

引用次数: 0

Feasibility of a Cardiac Magnetic Resonance Protocol for “off-on” Cardiac Resynchronization Therapy Evaluation 用于 "脱机 "心脏再同步化疗法评估的心脏磁共振方案的可行性

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques

Pub Date : 2024-10-18 DOI: 10.1111/echo.70003

Christian Basile, Alessandra Scatteia, Daniele Giacopelli, Paolo Gallo, Salvatore Pezzullo, Costantino Mancusi, Carmine E. Pascale, Paola Gargiulo, Federica Marzano, Pasquale Perrone-Filardi, Stefania Paolillo, Santo Dellegrottaglie

Background

Cardiac resynchronization therapy (CRT) is a standard treatment for patients with heart failure and electrical dyssynchrony. Cardiac magnetic resonance (CMR) is the gold standard for assessing left ventricular (LV) function. However, the feasibility of using CMR with active CRT is still uncertain.

Purpose

To assess the feasibility of a CRT “off-on” protocol during CMR and measure the acute effects of CRT interruption on LV function.

Methods

Patients underwent CMR before (pre-CRT) and 6 months after (post-CRT) an MR-conditional CRT defibrillator implantation. The post-CRT scan included two complete sets of cine images, one with inactive (post-CRT_OFF) and one with active CRT (post-CRT_ON), maintaining a continuous connection between device and programmer.

Results

Out of 29 enrolled patients, 8 (28%) had complete and analyzable post-CRT data. Unsuccessful procedures were attributed to connection problems between the CRT device and the programmer (n = 10), poor image quality (n = 7), and lack of patient cooperation (n = 4). LV ejection fraction significantly increased between pre-CRT scan (28.1%) and both post-CRT_OFF (37.9%; p = 0.046) and post-CRT_ON CMR (35.0%; p = 0.037), with a nonstatistically significant trend toward decreased LV volumes. No adverse events or significant changes in device electrical parameters (including battery level) were detected during the post-CMR scan period.

Conclusion

A CRT “off-on” protocol during CMR studies can be safely executed in patients with an MR-conditional CRT defibrillator. However, technical improvements are needed to facilitate high-quality scans during active CRT. Favorable changes in LV function induced by CRT remodeling were not acutely reversed with the interruption of electrical therapy.

背景心脏再同步化疗法（CRT）是心力衰竭和心电不同步患者的标准治疗方法。心脏磁共振（CMR）是评估左心室（LV）功能的黄金标准。然而，在主动 CRT 中使用 CMR 的可行性仍不确定。目的评估 CMR 期间 CRT "关闭-开启 "方案的可行性，并测量 CRT 中断对左心室功能的急性影响。方法患者在植入 MR 条件性 CRT 除颤器之前（CRT 前）和之后 6 个月（CRT 后）接受 CMR 扫描。CRT后扫描包括两组完整的CT图像，一组为非激活状态（CRTOFF后），另一组为激活状态（CRTON后），保持设备和编程器之间的连续连接。结果在 29 名注册患者中，有 8 人（28%）获得了完整的可分析 CRT 后数据。手术不成功的原因包括 CRT 设备与编程器之间的连接问题（10 例）、图像质量差（7 例）和患者不配合（4 例）。CRT扫描前（28.1%）和CRTOFF后（37.9%；P = 0.046）及CRTON CMR后（35.0%；P = 0.037）的左心室射血分数均有明显增加，左心室容积呈下降趋势，但无统计学意义。CMR扫描后期间未发现不良事件或设备电气参数（包括电池电量）的重大变化。结论 CMR 研究期间的 CRT "关闭-开启 "方案可在使用 MR 条件性 CRT 除颤器的患者中安全执行。但是，需要改进技术，以便在主动 CRT 期间进行高质量扫描。CRT 重塑引起的左心室功能的有利变化不会因电治疗的中断而急剧逆转。

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引用次数: 0

A Case of Invasive Thymoma Complicated by Multiple Metastases 一例并发多处转移的侵袭性胸腺瘤病例

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques

Pub Date : 2024-10-17 DOI: 10.1111/echo.15947

Yuqiong An, Fang Nie

Thymoma is a relatively uncommon thoracic solid tumor, and considered to possess malignant potential. Usually, the lung, pleura, and mediastinum are the most frequently affected sites for metastasis in thymoma. However, the thymoma presenting simultaneous intrathoracic and extrathoracic metastases are exceedingly rare. Herein, we present an exceptionally uncommon case of invasive thymoma with multiple metastases. Furthermore, our case underscores the indispensable role of multimodality imaging in confirming the primary diagnosis and guiding treatment decisions.

胸腺瘤是一种较为少见的胸部实体瘤，被认为具有恶性潜能。通常，肺、胸膜和纵隔是胸腺瘤最常见的转移部位。然而，胸腺瘤同时出现胸腔内和胸腔外转移的情况却极为罕见。在此，我们介绍了一例非常罕见的伴有多处转移的侵袭性胸腺瘤病例。此外，我们的病例还强调了多模式成像在确诊原发诊断和指导治疗决策中不可或缺的作用。

引用次数: 0

Supra-Aortic Branch Occlusion From Takayasu Arteritis 高安动脉炎引起的主动脉上支闭塞

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques

Pub Date : 2024-10-17 DOI: 10.1111/echo.15961

Muhammed Tekinhatun, Faruk Ertaş

This illustration depicts the complete occlusion of all supra-aortic branches due to Takayasu arteritis, as shown in invasive coronary angiography and CT angiography (a) Catheter angiography showing the occluded branches of the aortic arch (*). (b) Sagittal CT angiography showing calcification in the occluded supra-aortic branches (arrows) and thickened aortic wall (dashed arrow).

该插图描述了有创冠状动脉造影和 CT 血管造影显示的高安动脉炎导致主动脉上分支完全闭塞的情况 (a) 导管血管造影显示主动脉弓分支闭塞（*）。(b）矢状 CT 血管造影显示闭塞的主动脉上分支钙化（箭头）和主动脉壁增厚（虚线箭头）。

引用次数: 0

Efficacy and Safety of Transthoracic Versus Transesophageal Echocardiography for Monitoring Closure of Atrial or Ventricular Septal Defects: A Systematic Review and Meta-Analysis 经胸超声心动图与经食道超声心动图监测心房或室间隔缺损闭合的有效性和安全性：系统回顾与元分析

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques

Pub Date : 2024-10-16 DOI: 10.1111/echo.15955

Lele Ben, Yuanhao Zhang, Yu Wang, Weizhen Xing, Jianping Cai, Yu Han

Purpose

For the repair of atrial/ventricular septal defects (ASD/VSD), transthoracic echocardiography (TTE) is easy to perform, cost-effective, and does not require general anesthesia and intubation. Still, TTE is not universally accepted. To compare efficacy and safety of TTE versus transesophageal echocardiography (TEE) to guide percutaneous ASD/VSD closure.

Methods

PubMed, Embase, and the Cochrane library were searched for articles published from their inception to December 2023. The primary outcome was the procedural success rate. The secondary outcomes were residual shunt, late complications, procedure time, and fluoroscopy time. All meta-analyses were performed using a random-effects model.

Results

Eight studies and 1295 patients were included. There were no significant differences between TTE and TEE regarding the procedural success rate (OR = 1.93, 95% CI: 0.90–4.13, p = 0.092; I² = 52.2%, P_{heterogeneity} = 0.063) and residual shunt rate (OR = 0.81, 95% CI: 0.38–1.76, p = 0.600; I² = 0%, P_{heterogeneity} = 0.518). Compared with TEE, TTE reduced the frequency of late complications (OR = 0.25, 95% CI: 0.14–0.43, p < 0.001; I² = 13.8%, P_{heterogeneity} = 0.326), reduced the procedure time (WMD = −8.92, 95% CI: −12.08, −5.75, p < 0.001; I² = 87.4%, P_{heterogeneity} < 0.001), and reduced the fluoroscopy time (WMD = −5.08, 95% CI: −9.59, −0.56, p = 0.028; I² = 95.6%, P_{heterogeneity} < 0.001). The sensitivity analyses showed that the results of the meta-analyses were robust.

Conclusion

Compared with TEE, TTE showed no differences regarding the rates of success and residual shunt, but there were lower rates of late complications and shorter procedure and fluoroscopy times.

目的对于修复房间隔缺损/室间隔缺损（ASD/VSD），经胸超声心动图（TTE）操作简便、成本效益高，且无需全身麻醉和插管。尽管如此，TTE 仍未被普遍接受。目的比较 TTE 与经食道超声心动图 (TEE) 在指导经皮 ASD/VSD 关闭术中的有效性和安全性。方法在 PubMed、Embase 和 Cochrane 图书馆中检索从开始到 2023 年 12 月发表的文章。主要结果是手术成功率。次要结果为残余分流、晚期并发症、手术时间和透视时间。所有荟萃分析均采用随机效应模型。结果共纳入 8 项研究和 1295 名患者。TTE 和 TEE 在手术成功率（OR = 1.93，95% CI：0.90-4.13，p = 0.092；I2 = 52.2%，Pheterogeneity = 0.063）和残余分流率（OR = 0.81，95% CI：0.38-1.76，p = 0.600；I2 = 0%，Pheterogeneity = 0.518）方面无明显差异。与 TEE 相比，TTE 降低了晚期并发症的发生频率（OR = 0.25，95% CI：0.14-0.43，p <；0.001；I2 = 13.8%，Pheterogeneity = 0.326），缩短了手术时间（WMD = -8.92，95% CI：-12.08, -5.75, p < 0.001; I2 = 87.4%, Pheterogeneity < 0.001），减少了透视时间（WMD = -5.08, 95% CI: -9.59, -0.56, p = 0.028; I2 = 95.6%, Pheterogeneity < 0.001）。敏感性分析表明，荟萃分析的结果是稳健的。结论与 TEE 相比，TTE 在成功率和残余分流方面没有差异，但晚期并发症发生率较低，手术和透视时间较短。

{"title":"Efficacy and Safety of Transthoracic Versus Transesophageal Echocardiography for Monitoring Closure of Atrial or Ventricular Septal Defects: A Systematic Review and Meta-Analysis","authors":"Lele Ben, Yuanhao Zhang, Yu Wang, Weizhen Xing, Jianping Cai, Yu Han","doi":"10.1111/echo.15955","DOIUrl":"https://doi.org/10.1111/echo.15955","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>For the repair of atrial/ventricular septal defects (ASD/VSD), transthoracic echocardiography (TTE) is easy to perform, cost-effective, and does not require general anesthesia and intubation. Still, TTE is not universally accepted. To compare efficacy and safety of TTE versus transesophageal echocardiography (TEE) to guide percutaneous ASD/VSD closure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PubMed, Embase, and the Cochrane library were searched for articles published from their inception to December 2023. The primary outcome was the procedural success rate. The secondary outcomes were residual shunt, late complications, procedure time, and fluoroscopy time. All meta-analyses were performed using a random-effects model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eight studies and 1295 patients were included. There were no significant differences between TTE and TEE regarding the procedural success rate (OR = 1.93, 95% CI: 0.90–4.13, <i>p</i> = 0.092; <i>I</i><sup>2</sup> = 52.2%, <i>P</i><sub>heterogeneity</sub> = 0.063) and residual shunt rate (OR = 0.81, 95% CI: 0.38–1.76, <i>p</i> = 0.600; <i>I</i><sup>2</sup> = 0%, <i>P</i><sub>heterogeneity</sub> = 0.518). Compared with TEE, TTE reduced the frequency of late complications (OR = 0.25, 95% CI: 0.14–0.43, <i>p</i> < 0.001; <i>I</i><sup>2</sup> = 13.8%, <i>P</i><sub>heterogeneity</sub> = 0.326), reduced the procedure time (WMD = −8.92, 95% CI: −12.08, −5.75, <i>p</i> < 0.001; <i>I</i><sup>2</sup> = 87.4%, <i>P</i><sub>heterogeneity</sub> < 0.001), and reduced the fluoroscopy time (WMD = −5.08, 95% CI: −9.59, −0.56, <i>p</i> = 0.028; <i>I</i><sup>2</sup> = 95.6%, <i>P</i><sub>heterogeneity</sub> < 0.001). The sensitivity analyses showed that the results of the meta-analyses were robust.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Compared with TEE, TTE showed no differences regarding the rates of success and residual shunt, but there were lower rates of late complications and shorter procedure and fluoroscopy times.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"41 10","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.15955","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142443369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Transmitral Pressure Gradients in Patients With Degenerative Mitral Regurgitation After Robotic Mitral Valve Repair With Leaflet Preservation Techniques 采用保留瓣叶技术进行机器人二尖瓣修复术后退行性二尖瓣反流患者的跨瓣膜压力梯度

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques

Pub Date : 2024-10-16 DOI: 10.1111/echo.70001

Madison I. Goldberger, Angela Pollak, Matthew Fuller, Katherine Sun, Fawaz Alenezi, Donald Glower, Alina Nicoara

Introduction

The hemodynamic effects of mitral valve repair (MVr) with respect to transmitral pressure gradients (TMPGs) have not been described well in patients undergoing leaflet preservation techniques. In a population of patients undergoing robotic MVr with leaflet preservation, we investigate the expected change of the postrepair intraoperative TMPG in the postoperative follow-up period.

Methods

We retrospectively studied 144 adult patients who underwent robotic MVr. Demographic, clinical, procedural, and echocardiographic data were collected and analyzed.

Results

We found a slight increase in the mean TMPG from the intraoperative postrepair to the immediate postoperative period (intraoperative 3.3 ± 1.4 mmHg vs. first postoperative transthoracic echocardiography [TTE] follow-up 3.6 ± 1.9 mmHg, p = 0.016) with a gradual decline in the long-term follow-up (mean TMPG at last follow-up TTE 2.4+2.1 mmHg). When dichotomizing the patient population using a cutoff of 3 mmHg for the intraoperative mean TMPG, patients with an intraoperative mean TMPG > 3 mmHg had higher mean TMPG gradients at first TTE (4.5 ± 2.4 vs. 3.1 ± 1.3 mmHg, p < 0.001) as well as at last TTE (3.0± 2.2 vs. 2.1 ± 2.0 mmHg, p = 0.01) when compared with patients with an intraoperative mean TMPG ≤ 3 mmHg. There was no difference in clinical outcomes.

Conclusions

Although the hemodynamic effect of MVr seems to be small, patients with an intraoperative TMPG > 3 mmHg have a higher mean TMPG at follow-up. The hemodynamic effect does not seem to have an impact on clinical outcome.

导言：在接受瓣叶保留技术的患者中，二尖瓣修复术（MVr）对透瓣压力梯度（TMPGs）的血流动力学影响尚未得到很好的描述。在接受机器人二尖瓣置换术并保留瓣叶的患者中，我们研究了术后随访期间修复术中 TMPG 的预期变化。方法我们对 144 名接受机器人中风手术的成年患者进行了回顾性研究。收集并分析了人口统计学、临床、手术和超声心动图数据。结果我们发现，从术中修复后到术后近期，平均 TMPG 略有增加（术中 3.3 ± 1.4 mmHg vs. 术后首次经胸超声心动图 [TTE] 随访 3.6 ± 1.9 mmHg，p = 0.016），但在长期随访中逐渐下降（最后一次 TTE 随访时的平均 TMPG 为 2.4+2.1 mmHg）。当使用术中平均 TMPG 3 mmHg 临界值对患者人群进行二分时，术中平均 TMPG > 3 mmHg 的患者在首次 TTE 时的平均 TMPG 梯度更高（4.与术中平均 TMPG ≤ 3 mmHg 的患者相比，术中平均 TMPG ≥ 3 mmHg 的患者在第一次 TTE（4.5 ± 2.4 vs. 3.1 ± 1.3 mmHg，p = 0.001）和最后一次 TTE（3.0± 2.2 vs. 2.1 ± 2.0 mmHg，p = 0.01）时的平均 TMPG 梯度更高。临床结果无差异。结论虽然 MVr 对血液动力学的影响似乎很小，但术中 TMPG > 3 mmHg 的患者随访时平均 TMPG 较高。血液动力学效应似乎对临床结果没有影响。

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