积极的血压反应可预测经导管主动脉瓣植入术后肾功能的恢复。

IF 1.2 4区 医学 Q4 PERIPHERAL VASCULAR DISEASE Blood Pressure Monitoring Pub Date : 2024-02-01 Epub Date: 2023-09-14 DOI:10.1097/MBP.0000000000000676
Orhan Ince, Kamil Gulsen, Sevgi Ozcan, Sevil Tugrul, Fahrettin Katkat, Serkan Karahan, Esra Donmez, Alper Kepez, Irfan Sahin, Ertugrul Okuyan
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引用次数: 0

摘要

目的:经导管主动脉瓣植入术(TAVI经导管主动脉瓣植入术(TAVI)可改善肾功能并增加血压(BP)。我们旨在研究 TAVI 术后血压升高与肾功能改善(IRF)之间的关系:我们对 176 名接受 TAVI 的患者进行了回顾性评估。回顾性分析了 TAVI 术前 24 小时和术后 72 小时的血压记录。记录了手术前、手术后 48 小时和第一个月的估计肾小球滤过率(eGFR)水平。eGFR增加≥10%即为IRF。研究了 48 小时内急性肾损伤(AKI)发生和 1 个月内 IRF 的预测因素。评估了死亡率与血压反应之间的关系:根据研究方法的规定,共有 157 名患者被纳入本研究。平均年龄为 78.1±7.1 岁,51.6% 为女性。25.5%的患者发生了 AKI,基线 eGFR 和男性性别是发生 AKI 的独立预测因素。16% 的患者在 48 小时后出现 IRF,31.8% 的患者在随访 1 个月后出现 IRF。42%的患者出现了积极的血压反应。术前慢性肾病、阳性血压反应和早期 eGFR 增高成为第一个月出现 IRF 的独立预测因素。血压反应阳性的患者在随访710天时死亡率降低:结论:TAVI 术后血压反应阳性与生存和肾功能改善有关。结论:TAVI 术后血压反应阳性与生存率和肾功能的改善有关,TAVI 对肾功能的有益影响可在第一个月而非 48 小时进行精确评估。
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Positive blood pressure response may predict the recovery of renal function after transcatheter aortic valve implantation.

Objective: Transcatheter aortic valve implantation (TAVI) may ameliorate renal function and increase blood pressure (BP). We aimed to investigate the association between increased BP and improved renal function (IRF) after TAVI.

Methods: A total of 176 patients who had undergone TAVI were evaluated retrospectively. BP records that were taken 24 h before and 72 h after TAVI were reviewed. Pre-procedural, post-procedural 48 h, and the first month estimated glomerular filtration rate (eGFR) levels were noted. IRF was accepted as a ≥ 10% increase in eGFR. The predictors of acute kidney injury (AKI) development at 48 h and IRF at 1 month were investigated. The association between mortality and BP response was assessed.

Results: A total of 157 patients were included in this study after exclusion as defined in the methodology. Mean age was 78.1 ± 7,1 and 51.6% were female. AKI occurred in 25.5% of patients and baseline eGFR and male gender were found as independent predictors for AKI development. IRF was observed in 16% at 48 h and 31.8% of patients at 1-month follow-up. Positive BP response was seen in 42% of patients. Pre-procedural chronic kidney disease, positive BP response, and an early increase in eGFR emerged as independent predictors of IRF at the first month. The patients with positive BP response were found to have decreased mortality at 710 days follow-up.

Conclusion: Positive BP response after TAVI is related to improved survival and renal functions. The beneficial effect of TAVI on renal function may be precisely evaluated at 1st month rather than 48 h.

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来源期刊
Blood Pressure Monitoring
Blood Pressure Monitoring 医学-外周血管病
CiteScore
2.00
自引率
7.70%
发文量
110
审稿时长
>12 weeks
期刊介绍: Blood Pressure Monitoring is devoted to original research in blood pressure measurement and blood pressure variability. It includes device technology, analytical methodology of blood pressure over time and its variability, clinical trials - including, but not limited to, pharmacology - involving blood pressure monitoring, blood pressure reactivity, patient evaluation, and outcomes and effectiveness research. This innovative journal contains papers dealing with all aspects of manual, automated, and ambulatory monitoring. Basic and clinical science papers are considered although the emphasis is on clinical medicine. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.
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