重度主动脉瓣狭窄患者经导管主动脉瓣置换术后左室射血分数的变化

Shailesh Singh, A. Khan, Katyayni Singh
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摘要

背景:长期主动脉瓣狭窄(AS)导致左室(LV)压力升高,结果导致左室肥厚和心肌纤维化增加。左室射血分数(LVEF)通常保留到疾病晚期,但严重AS患者可出现轻微的左室功能障碍。经导管主动脉瓣置换术(Transcatheter aortic valve replacement, TAVR)已成为中高手术风险AS患者主动脉瓣置换术的主要方法。在本研究中,我们的目的是观察严重AS患者的TAVR是否可以改善收缩功能。对象和方法:我们回顾性研究了52例在本中心连续接受TAVR治疗的严重症状性AS患者的资料。在基线和手术后6个月进行超声心动图检查以评估LVEF的变化。结果:对52例患者进行回顾性评价。TAVR前平均LVEF为49.52±13.44。TAVR术后平均LVEF为52.02±10.95。这意味着与TAVR前的LVEF相比,TAVR后LVEF显著增加(使用Wilcoxon符号秩检验P = 0.008)。结论:在本文中,我们得出结论,在AS患者中,通过LVEF评估,TAVR去除后负荷可显着改善心功能。
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Change in left ventricular ejection fraction after transcatheter aortic valve replacement in severe aortic stenosis
Background: Long-standing aortic stenosis (AS) leads to elevated left ventricular (LV) pressure and as a consequence develops LV hypertrophy and increased myocardial fibrosis. The LV ejection fraction (LVEF) remains often preserved until the late stages of disease, but subtle LV dysfunction can be present in patients of severe AS. Transcatheter aortic valve replacement (TAVR) has become the primary method of aortic valve replacement for intermediate and high surgical risk patients with AS. In this study, we aimed to see if TAVR in patients with severe AS can result in the improvement of systolic functions. Subjects and Methods: We retrospectively studied the data of 52 consecutive symptomatic patients with severe symptomatic AS who underwent TAVR at our center. Echocardiography was performed at baseline and 6 months after the procedure to evaluate change in LVEF. Results: Fifty-two patients were retrospectively evaluated. The mean LVEF before TAVR was 49.52 ± 13.44. The mean LVEF after TAVR was 52.02 ± 10.95. That means there was a significant increase in LVEF after TAVR as compared to LVEF before TAVR (P = 0.008 using Wilcoxon signed-rank test). Conclusion: In this article, we conclude that, in AS patients, the removal of afterload by TAVR significantly improves cardiac functions as assessed by LVEF.
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