American Journal of Cardiology最新文献

Effectiveness and Safety of Apixaban Versus Warfarin in Atrial Fibrillation Patients with Malignancy: A Propensity-Matched Analysis 阿哌沙班与华法林在恶性心房颤动患者中的有效性和安全性：倾向匹配分析。

IF 2.1 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology

Pub Date : 2026-04-01 Epub Date: 2026-01-17 DOI: 10.1016/j.amjcard.2026.01.006

Siddharth P. Agrawal MD , Ritu Tated MBBS, MPH , Hritvik Jain MBBS , Kriti Soni MD , Dhruvi K. Joshi MBBS , Pragyat Futela MD , Maharshi Raval MD , Vikas Aggarwal MD , Abhishek Deshmukh MD , Saraschandra Vallabhajosyula MD, MSc

Patients with atrial fibrillation and malignancy have increased risks of thromboembolism and bleeding. Evidence comparing apixaban and warfarin in this group remains limited. We aimed to compare effectiveness and safety of apixaban versus warfarin in patients with atrial fibrillation and active malignancy using real-world data from a large multinational cohort. This retrospective cohort study used the TriNetX Global Collaborative Network, de-identified records from 146 healthcare organizations between December 1, 2012, and May 1, 2025. Atrial fibrillation patients with malignancy receiving apixaban or warfarin were matched 1:1 using propensity scores across 74 clinical variables. Outcomes were assessed at 3 months, 6 months, 1 year, and 5 years. Primary endpoints included all-cause mortality, stroke, pulmonary embolism, deep vein thrombosis, gastrointestinal bleeding and intracranial hemorrhage. In this 12.5-year period, 41,764 matched pairs of patients were analyzed. Compared to the warfarin cohort, the apixaban cohort demonstrated lower all-cause mortality at 3 months (OR: 1.05, 95% CI: 1.00–1.10), 6 months (OR: 1.05, 95% CI: 1.01–1.09), 1 year (OR: 1.06, 95% CI: 1.03–1.10), and 5 years (OR: 1.17, 95% CI: 1.13–1.20; all p <0.05). Stroke rates were comparable between groups, while pulmonary embolism, deep vein thrombosis, gastrointestinal bleeding and intracranial hemorrhage were noted less frequent with apixaban. Kaplan–Meier analyses showed early and sustained differences in survival and bleeding outcomes. In conclusion, in atrial fibrillation patients with cancer, apixaban was associated with lower mortality and major bleeding without increasing stroke risk compared to warfarin.

心房颤动和恶性肿瘤患者血栓栓塞和出血的风险增加。比较阿哌沙班和华法林在该组中的疗效的证据仍然有限。我们的目的是比较阿哌沙班和华法林在心房颤动和活动性恶性肿瘤患者中的有效性和安全性，使用来自大型跨国队列的真实世界数据。这项回顾性队列研究使用TriNetX全球协作网络，收集了2012年12月1日至2025年5月1日期间146家医疗机构的去识别记录。接受阿哌沙班或华法林治疗的恶性心房颤动患者在74个临床变量中使用倾向评分进行1:1匹配。结果在3个月、6个月、1年和5年进行评估。主要终点包括全因死亡率、中风、肺栓塞、深静脉血栓形成、胃肠道出血和颅内出血。在这12.5年的时间里，分析了41764对匹配的患者。与华法林组相比，阿哌沙班组在3个月（OR: 1.05, 95% CI: 1.00-1.10）、6个月（OR: 1.05, 95% CI: 1.01-1.09）、1年（OR: 1.06, 95% CI: 1.03-1.10）和5年（OR: 1.17, 95% CI: 1.13-1.20，均p < 0.05）的全因死亡率较低。两组间卒中发生率相当，而肺栓塞、深静脉血栓形成、胃肠道出血和颅内出血发生率较阿哌沙班组低。Kaplan-Meier分析显示了早期和持续的生存和出血结果差异。总之，与华法林相比，在伴有癌症的房颤患者中，阿哌沙班与较低的死亡率和大出血相关，而不会增加卒中风险。

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引用次数: 0

Real-World Suitability of Patients for Transcatheter Tricuspid Valve Replacement 经导管三尖瓣置换术患者的实际适用性。

IF 2.1 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology

Pub Date : 2026-04-01 Epub Date: 2026-01-16 DOI: 10.1016/j.amjcard.2026.01.002

Tyler Andrews DO , Ritik Patel BS , Muhtasim Jaigirdar MD , PedroEngel Gonzalez MD , Dimitrios Apostolou MD , James Lee MD , John Dawdy MD , Bryan Zweig MD , Raed Alnajjar MD , Tiberio M. Frisoli MD , Pedro Villablanca MD , Brian P. O’Neill MD

Transcatheter tricuspid valve replacement (TTVR) has shown therapeutic promise for patients with severe tricuspid regurgitation (TR). However, some patients may not be eligible due to anatomic limitations. We sought to describe the outcomes of patients who were referred for transcatheter tricuspid valve intervention (TTVI) and were ineligible for TTVR. This was a single-center, retrospective study of 251 patients referred for TTVI from February 2024 to August 2025. All patients were considered by a multidisciplinary heart team and assessed for feasibility of commercial tricuspid valve repair or replacement, with a strategy to proceed with replacement if anatomically feasible. Data on demographics, clinical characteristics, and outcomes were collected from medical records. Of 251 patients evaluated, 43 (17.1%) were unsuitable for TTVR. Compared with suitable patients, unsuitable patients were more frequently male (67.4% vs 33.2%, p <0.01) and more likely to have implanted electronic device (53.5% vs 32.2%, p = 0.01) or prior tricuspid interventions (7.9% vs 1.6%, p = 0.03). The leading reason for unsuitability was large annular dimensions (60.5%), followed by leaflet tethering (14.0%) and small annular size (11.6%). Of the unsuitable cohort, 10 patients (23.3%) underwent T-TEER and 33 (76.7%) received medical therapy alone. T-TEER resulted in significant reduction in TR severity (p = 0.034), though 80% had residual moderate or greater TR. In conclusion, this commercial experience, rates of TTVR ineligibility were lower than previously described with large annular dimensions serving as the most frequent exclusion criterion. For those ineligible, T-TEER may provide a feasible approach in appropriately selected patients.

经导管三尖瓣置换术（TTVR）已显示出治疗严重三尖瓣反流（TR）患者的希望。然而，由于解剖结构的限制，一些患者可能不符合条件。我们试图描述转介经导管三尖瓣介入治疗（TTVI）且不符合TTVR条件的患者的结果。这是一项单中心回顾性研究，从2024年2月到2025年8月，251例TTVI患者被转诊。所有的患者都由一个多学科的心脏团队进行考虑，并评估商业三尖瓣修复或置换的可行性，如果解剖上可行，就继续进行置换。从医疗记录中收集人口统计学、临床特征和结果的数据。251例患者中，43例（17.1%）不适合TTVR。与适宜患者相比，不适宜患者以男性居多(67.4% vs. 33.2%, p

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引用次数: 0

Pregnancy Outcomes in Women with Cardiovascular Disease:A Retrospective Cohort Study from Kaiser Permanente Northern California 心血管疾病妇女的妊娠结局：一项来自北加州凯撒医疗机构的回顾性队列研究

IF 2.1 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology

Pub Date : 2026-04-01 Epub Date: 2026-01-16 DOI: 10.1016/j.amjcard.2026.01.003

Ekta Partani MD , Carol Shi MD , Douglas Stram MS , Samhita Palakodeti MD , Marisa McDonald BSN, RN , Cynthia Triplett MPH, MA , Jennifer Ting MD , Megan L. Stephenson MD , Nikhil Joshi MD , Seema K. Pursnani MD, MPH

Cardiovascular disease (CVD) remains a leading cause of maternal mortality in the United States, comprising 26.5% of pregnancy-related deaths. We sought to evaluate trends in CVD during pregnancy and maternal, obstetric, and fetal outcomes in pregnant women with CVD in the Kaiser Permanente Northern California (KPNC) integrated healthcare system. This retrospective cohort study included adult KPNC members with moderate or greater valvular heart disease, cardiomyopathy, congenital heart disease, or ischemic heart disease during pregnancy from 2010 to 2021. Bivariate analyses and multivariable logistic regression were used to evaluate associations between demographic and clinical risk factors and maternal outcomes in pregnant patients with CVD. Of 320,902 pregnancies, 763 (0.24%) were identified with clinically significant CVD. The prevalence of CVD increased from 0.19% to 0.34% over the decade, predominantly due to an increase in prevalence of women with congenital heart disease. Mean gestational age at delivery was 36.7 weeks with 19.5% experiencing preterm delivery. Cesarean section, pre-eclampsia or eclampsia, and postpartum hemorrhage rates were 29.5%, 20.8%, and 9.7%, respectively. Fetal loss beyond the first trimester occurred in 7.1% pregnancies. Adverse maternal cardiac outcomes occurred in 55 (7.2%) of patients, predominantly driven by congestive heart failure hospitalizations. There were 4 deaths (0.5%) during pregnancy or within 1 year postpartum. Pre-existing CVD (aOR 0.20, p = 0.002) and cardiac medication use (aOR 4.13, p <0.001) were significant predictors of adverse maternal outcomes. Higher left ventricular ejection fraction (aOR 0.95, p = 0.018) was associated with lower odds of adverse maternal outcomes. In conclusion, understanding risk factors for adverse pregnancy outcomes in a diverse, contemporary population of patients with CVD can help refine cardio-obstetric risk assessment and preconception counseling.

心血管疾病（CVD）仍然是美国孕产妇死亡的主要原因，占妊娠相关死亡的26.5%。我们试图在Kaiser Permanente北加州（KPNC）综合医疗保健系统中评估怀孕期间CVD的趋势以及患有CVD的孕妇的孕产妇、产科和胎儿结局。这项回顾性队列研究纳入了2010-2021年妊娠期间患有中度或更严重瓣膜病、心肌病、先天性心脏病或缺血性心脏病的成年KPNC成员。使用双变量分析和多变量logistic回归来评估人口统计学和临床危险因素与妊娠CVD患者产妇结局之间的关系。在320902例妊娠中，763例（0.24%）被诊断为临床显著的心血管疾病。在过去十年中，心血管疾病的患病率从0.19%增加到0.34%，主要是由于患有先天性心脏病的妇女患病率增加。平均胎龄36.7周，19.5%早产。剖宫产、先兆子痫或子痫、产后出血率分别为29.5%、20.8%、9.7%。7.1%的妊娠发生在妊娠早期以后的胎儿丢失。55例（7.2%）患者发生了不良的产妇心脏结局，主要是由于充血性心力衰竭住院所致。妊娠期间或产后1年内死亡4例（0.5%）。既往心血管疾病（aOR 0.20, p=0.002）和心脏药物使用（aOR 4.13, p=0.002）

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引用次数: 0

Assessment of ischemic stroke risk in patients withatrial fibrillation after ablation. 房颤消融后缺血性卒中风险评估。

IF 2.1 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology

Pub Date : 2026-03-21 DOI: 10.1016/j.amjcard.2026.03.030

Xinyin Xie, Hui Zeng, Min Yu

引用次数: 0

Comment on "The Long-Term Clinical Progression of Genotype Positive/Phenotype Negative Patients with Hypertrophic Cardiomyopathy". “基因型阳性/表型阴性肥厚性心肌病患者的长期临床进展”评论。

IF 2.1 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology

Pub Date : 2026-03-20 DOI: 10.1016/j.amjcard.2026.03.026

Raffaella Lombardi, Grazia Canciello, Leopoldo Ordine

引用次数: 0

Early Tirzepatide Use After Acute Myocardial Infarction or Ischemic Stroke in Patients Without Diabetes: A Real-World Propensity-Matched Study. 非糖尿病患者急性心肌梗死或缺血性卒中后早期使用替西肽：一项真实世界倾向匹配研究

IF 2.1 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology

Pub Date : 2026-03-18 DOI: 10.1016/j.amjcard.2026.03.020

Ibrahim Mortada, Aaron Lee, Valerie Quach, James Rice, Shareef Mansour, Khaled Chatila, Mostafa Shalaby, Thomas Blackwell, Hani Jneid

Tirzepatide has demonstrated cardiometabolic benefits in clinical trials, but real-world cardiovascular outcomes among patients without diabetes following acute cardiovascular events or stroke remain understudied. We evaluated clinical outcomes associated with early tirzepatide use after acute myocardial infarction (AMI) or ischemic stroke in patients without diabetes. We conducted a retrospective study using the TriNetX Research Network (110 healthcare organizations). Adults ≥18 years and BMI ≥27 kg/m² without diabetes, with AMI or ischemic stroke from June 2022 to November 2025 were included. Patients treated with tirzepatide within 14 days of AMI/stroke were compared with those not receiving tirzepatide. Propensity score matching (1:1) across 28 covariates balanced demographics, comorbidities, medications, and laboratory values, yielding 833 patients per cohort. Outcomes were assessed over 2 years and included all-cause emergency room (ER) visit or hospitalization, acute kidney injury (AKI), ischemic stroke, heart-failure hospitalization, and major adverse cardiovascular events (MACE). Cox proportional hazard models were used to estimate hazard ratios (HRs). After matching, tirzepatide use was associated with significantly lower risk of all-cause ER visit or hospitalization (HR 0.64, 95% CI 0.548-0.741), AKI (HR 0.65, 95% CI 0.441-0.962), ischemic stroke (HR 0.82, 95% CI 0.703-0.947), and heart-failure hospitalization (HR 0.24, 95% CI 0.0001-0.383). MACE hazard did not differ significantly (HR 0.91, 95% CI 0.814-1.021). In conclusion, early tirzepatide initiation after AMI/stroke in patients without diabetes was associated with fewer hospitalizations and reduced renal, heart-failure, and stroke events. These findings support prospective trials of tirzepatide for secondary cardiovascular prevention in non-diabetic patients.

替西帕肽在临床试验中已显示出心脏代谢益处，但在急性心血管事件或中风后非糖尿病患者的真实心血管结局仍未得到充分研究。我们评估了非糖尿病患者急性心肌梗死（AMI）或缺血性卒中后早期使用替西肽的临床结果。我们使用TriNetX研究网络（110个医疗保健组织）进行了回顾性研究。在2022年6月至2025年11月期间，成人≥18岁，BMI≥27 kg/m²，无糖尿病，AMI或缺血性卒中。AMI/卒中后14天内接受替西肽治疗的患者与未接受替西肽治疗的患者进行比较。28个协变量的倾向评分匹配（1:1）平衡了人口统计学、合并症、药物和实验室值，每个队列产生833名患者。结果评估超过2年，包括全因急诊室（ER）就诊或住院、急性肾损伤（AKI）、缺血性中风、心力衰竭住院和主要不良心血管事件（MACE）。采用Cox比例风险模型估计风险比（hr）。匹配后，替西帕肽的使用显著降低了全因急诊就诊或住院的风险（HR 0.64, 95% CI 0.548-0.741）， AKI (HR 0.65, 95% CI 0.441-0.962)，缺血性卒中（HR 0.82, 95% CI 0.703-0.947）和心力衰竭住院（HR 0.24, 95% CI 0.0001-0.383）。MACE风险无显著差异（HR 0.91, 95% CI 0.814-1.021）。总之，非糖尿病患者AMI/卒中后早期使用替西帕肽可减少住院次数，减少肾脏、心力衰竭和卒中事件。这些发现支持替西肽用于非糖尿病患者心血管二级预防的前瞻性试验。

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引用次数: 0

The Outcomes of Percutaneous Mitral Balloon Valvuloplasty In Patients With Severe Rheumatic Mitral Stenosis and Left Atrial Appendage Thrombus: Systematic Review and Meta-Analysis. 经皮二尖瓣球囊成形术治疗严重风湿性二尖瓣狭窄和左心房附件血栓的疗效：系统评价和meta分析。

IF 2.1 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology

Pub Date : 2026-03-18 DOI: 10.1016/j.amjcard.2026.03.017

Prasham Dave, Melissa Y Y Moey, Abdullah Alfaifi, Thomas V Attumalil, Dev Pandya, Neil P Fam, Sami M Alnasser

Persistent left atrial appendage thrombus despite anticoagulation is common. Current guidelines advise against PMBV because of perceived thromboembolic risk, leaving surgical mitral valve replacement-an option associated with substantial morbidity-as the primary alternative. However, the procedural risk of PMBV in the setting of left atrial appendage thrombus remains poorly established. We conducted a systematic review and meta-analysis to assess this. Of the 2,136 studies identified in the initial search, 17 were included in the analysis, comprising 386 patients undergoing PMBV with LAA thrombus. The rate of stroke or embolic complication was 2.8% (95% CI 1.4% - 5.5%). No stroke or embolic complications occurred in Type Ia thrombus. In conclusion, LAA-confined thrombus (Type 1a) was not associated with embolic events, supporting a morphology-based approach to patient selection and emphasizing the need for prospective data to refine the current guidelines.

尽管抗凝，持续性左心耳血栓是常见的。目前的指南不建议PMBV，因为它有明显的血栓栓塞风险，而将手术二尖瓣置换术作为主要的替代方案。手术二尖瓣置换术是一种与大量发病率相关的选择。然而，在左心耳血栓的情况下，PMBV的手术风险仍然不太确定。我们进行了系统回顾和荟萃分析来评估这一点。在最初检索的2136项研究中，有17项纳入了分析，包括386例合并LAA血栓的PMBV患者。卒中或栓塞并发症发生率为2.8% （95% CI 1.4% - 5.5%）。Ia型血栓未发生卒中或栓塞并发症。总之，laa受限血栓（1a型）与栓塞事件无关，支持基于形态学的患者选择方法，并强调需要前瞻性数据来完善当前的指南。

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引用次数: 0

Comment on "The Effect of Vericiguat on Endothelial Function in Patients with Heart Failure with Reduced Ejection Fraction: A Pilot Randomized Study". “Vericiguat对心力衰竭伴射血分数降低患者内皮功能的影响：一项先导随机研究”评论。

IF 2.1 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology

Pub Date : 2026-03-17 DOI: 10.1016/j.amjcard.2026.03.027

Anuradha Mokkapati, Rhushvi Thakkar, Anjna Rani, Dinesh Puri

None.

无。

引用次数: 0

The Impact of Medicaid Enrollment on Care Pathways and Limb Outcomes among Patients with Chronic Limb-Threatening Ischemia. 医疗补助登记对慢性肢体缺血患者的护理途径和肢体结局的影响。

IF 2.1 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology

Pub Date : 2026-03-16 DOI: 10.1016/j.amjcard.2026.03.025

Maxime Dubosq-Lebaz, Joseph Kim, Siling Li, Yann Gouëffic, Jonathan Sobocinski, Eric Secemsky

Outcomes in chronic limb-threatening ischemia (CLTI) depend on timely revascularization and sustained continuity of specialty care. Although community-level socioeconomic disadvantage is associated with worse outcomes, the impact of individual-level socioeconomic vulnerability on longitudinal outcomes and healthcare utilization after CLTI revascularization remains unclear. We analyzed 333,173 Medicare beneficiaries who underwent CLTI revascularization between 2016 and 2023. Socioeconomic vulnerability was defined by Dual Enrolment (DE) in Medicaid. Outcomes were assessed using Kaplan-Meier analyses and multivariable Cox proportional hazards models. The primary clinical outcome was major amputation. A composite endpoint of major amputation or death was analyzed to contextualize overall disease burden. The study period was stratified into pre-COVID (01/2016-03/2020), COVID (03/2020-12/2021), and post-COVID (12/2021-12/2023) phases. Healthcare utilization was compared between DE and Medicare-only patients. Among included patients, 26.2% were DE. DE patients were younger, more frequently female, and had a higher comorbidity burden. The crude cumulative incidence of the primary outcome was higher in DE patients (80.1% vs. 79.7%; unadjusted HR 1.07, 95%CI 1.06-1.08), but this difference was not significant after adjustment (adjusted HR 1.00, 95%CI 0.99-1.01). DE patients had higher rates of major amputation (17.8% vs. 12.7%; adjusted HR 1.10, 95%CI 1.07-1.12), with no adjusted differences in repeat revascularization or all-cause mortality. During COVID, DE patients had a higher adjusted risk of the primary outcome (HR 1.05, 95%CI 1.02-1.08), whereas risks were similar pre- and post-pandemic. DE identifies CLTI patients at increased risk of limb loss despite similar adjusted survival, highlighting individual-level barriers to care continuity and the need for targeted strategies to reduce preventable amputations.

慢性肢体威胁缺血（CLTI）的预后取决于及时的血运重建和持续的专科护理。虽然社区层面的社会经济劣势与较差的结果相关，但个人层面的社会经济脆弱性对CLTI血运重建术后的纵向结果和医疗保健利用的影响尚不清楚。我们分析了2016年至2023年间接受CLTI血运重建术的333,173名医疗保险受益人。社会经济脆弱性通过医疗补助双登记（DE）来定义。使用Kaplan-Meier分析和多变量Cox比例风险模型评估结果。主要临床结果为主要截肢。分析了主要截肢或死亡的复合终点，以确定总体疾病负担的背景。研究阶段分为预冠期（2016年1月- 2020年3月）、新冠期（2020年3月- 2021年12月）和后冠期（2021年12月- 2023年12月）。比较DE患者和只参加医疗保险患者的医疗保健利用情况。在纳入的患者中，26.2%为DE。DE患者较年轻，多为女性，且有较高的合并症负担。主要结局的粗累积发生率在DE患者中较高（80.1% vs. 79.7%；未校正HR 1.07, 95%CI 1.06-1.08），但校正后差异不显著（校正HR 1.00, 95%CI 0.99-1.01）。DE患者的主要截肢率更高（17.8% vs. 12.7%；校正HR 1.10, 95%CI 1.07-1.12），但在重复血运重建和全因死亡率方面没有校正差异。在COVID期间，DE患者的主要结局调整风险较高（HR 1.05, 95%CI 1.02-1.08），而大流行前后的风险相似。DE识别出尽管有相似的调整生存期，但肢体丧失风险增加的CLTI患者，突出了个体层面的护理连续性障碍和减少可预防截肢的有针对性策略的必要性。

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引用次数: 0

Anomalous Attachment of the Posterior Mitral Annulus to the Crest of the Left Ventricle in Patients With Mitral Annular Disjunction (MAD) and Mitral Valve Prolapse 二尖瓣环分离（MAD）和二尖瓣脱垂患者的后二尖瓣环与左心室嵴的异常附着。

IF 2.1 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology

Pub Date : 2026-03-15 Epub Date: 2025-12-30 DOI: 10.1016/j.amjcard.2025.11.026

Jeffrey J. Silbiger MD , Oksana Marchenko MD, PhD , Raveen Bazaz MD , Priya Panday MD , Aviv Alter MD , Pedro Rafael Vieira De Olivera Salerno MD

The purpose of this study is to determine the site of attachment of the posterior mitral annulus to the left ventricle in patients with mitral annular disjunction (MAD) and mitral valve prolapse (MVP). The posterior annulus normally attaches to the inlet of the left ventricle. Some histological findings suggest that the disjunctive annulus may instead attach anomalously to the left ventricular (LV) crest in patients with MVP. We used cardiac magnetic resonance imaging to determine the site of attachment of the posterior mitral annulus (crest vs inlet) in 25 patients with MVP with MAD (MAD+ group) and 24 patients with MVP without MAD (MAD- group). The site of annular attachment was determined in the 3-chamber view during diastole. Our data demonstrate complete separation in mitral annular attachment site between MAD+ and MAD- groups. All patients in the MAD+ group demonstrated annular attachment to the LV crest, whereas all those in the MAD- group demonstrated annular attachment to the LV inlet (p <0.001). The presence of anomalous annular attachment in MAD+, but not MAD- patients, suggests this anatomic abnormality represents a feature of the MAD phenotype rather than the myxomatous phenotype. Anomalous annular attachment may potentially influence the arrhythmic potential of MAD.

本研究的目的是确定二尖瓣环分离（MAD）和二尖瓣脱垂（MVP）患者的后二尖瓣环与左心室的附着位置。后环通常与左心室入口相连。一些组织学结果表明，在MVP患者中，分离环可能异常附着在左心室（LV）嵴上。我们对25例合并MAD的MVP患者（MAD+组）和24例不合并MAD的MVP患者（MAD-组）采用心脏磁共振成像确定二尖瓣后环的附着位置（嵴vs入口）。在舒张期的三腔镜下确定环状附着的位置。我们的数据显示MAD+组和MAD-组之间二尖瓣环附着位点完全分离。MAD+组的所有患者均表现为左室冠的环形附着，而MAD-组的所有患者均表现为左室入口的环形附着（p < 0.001）。在MAD+患者中存在异常环状附着，而在MAD-患者中没有，这表明这种解剖异常代表了MAD表型的特征，而不是黏液瘤表型。异常的环状附着可能潜在地影响MAD的心律失常潜能。

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引用次数: 0