Impacto de prótesis valvular pulmonar en la función ventricular derecha y eventos cardiacos en pacientes con tetralogía de Fallot: análisis retrospectivo

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia Pub Date : 2024-03-16 DOI:10.1016/j.recesp.2023.11.010

Francisco Javier Ruperti-Repilado , Nora Haag , Thomas Fischer , Bruno Santos Lopes , Lukas Meier , Kerstin Wustmann , Francesca Bonassin , Christine Attenhofer Jost , Fabienne Schwitz , Markus Schwerzmann , Daniel Tobler , Stefanie von Felten , Matthias Greutmann

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Abstract

Introduction and objectives

Our aim was to assess the impact of prosthetic pulmonary valve replacement (PVR) in patients with repaired tetralogy of Fallot (rTOF) on changes in biventricular volumes and function and on adverse cardiac events.

Methods

Adults with rTOF were identified from the SACHER-registry. Data from serial cardiac magnetic resonance imaging, echocardiography, exercise capacity and n-terminal pro b-type natriuretic peptide (NT-proBNP) were collected. The primary endpoint was right ventricular ejection fraction (RVEF) as measured by cardiac magnetic resonance. Secondary endpoints were biventricular volumes, left ventricular ejection fraction, exercise capacity and NT-proBNP levels, and time to adverse cardiac outcomes (atrial and ventricular arrhythmia, endocarditis). Associations between previous PVR and longitudinal changes in functional outcomes and time to adverse cardiac outcomes were analyzed using linear mixed-effects models and Cox proportional hazards models, respectively.

Results

A total of 308 patients (153 with and 155 without PVR) with 887 study visits were analyzed. Previous PVR was not significantly associated with changes in RVEF (CE, - 1.33; 95%CI, - 5.87 to 3.21; P = .566). Previous PVR was associated with lower right ventricular end-diastolic volume but had no significant effect on left ventricular ejection fraction, exercise capacity, or NT-proBNP-levels. Previous PVR was associated with an increased hazard of atrial arrhythmias (HR, 2.09; 95%CI, 1.17-3.72; P = .012) and infective endocarditis (HR, 12.72; 95%CI, 4.69-34.49; P < .0001) but not with an increased hazard of sustained ventricular arrhythmias (HR, 0.64; 95%CI, 0.18-2.27; P = .490).

Conclusions

Previous PVR was not significantly associated with changes in RVEF but was associated with an increased risk of atrial arrhythmias and infective endocarditis.

查看原文本刊更多论文

肺动脉瓣置换术对法洛氏四联症患者右心室功能和心脏事件的影响：回顾性分析。

导言和目的我们的目的是评估人工肺动脉瓣置换术（PVR）对法洛氏四联症（rTOF）患者双心室容积和功能变化以及不良心脏事件的影响。收集了连续心脏磁共振成像、超声心动图、运动能力和 n-末端前 b 型钠尿肽（NT-proBNP）的数据。主要终点是心脏磁共振测量的右心室射血分数（RVEF）。次要终点是双心室容积、左室射血分数、运动能力、NT-proBNP 水平以及出现不良心脏预后（房性和室性心律失常、心内膜炎）的时间。采用线性混合效应模型和 Cox 比例危险模型分别分析了既往 PVR 与功能预后纵向变化和不良心脏预后发生时间之间的关系。既往 PVR 与 RVEF 的变化无明显相关性（CE，- 1.33；95%CI，- 5.87 至 3.21；P = .566）。既往 PVR 与右心室舒张末期容积降低有关，但对左心室射血分数、运动能力或 NT-proBNP 水平无明显影响。既往 PVR 与房性心律失常（HR，2.09；95%CI，1.17-3.72；P = .012）和感染性心内膜炎（HR，12.72；95%CI，4.69-34.49；P <；.0001）的危险增加有关，但与持续性室性心律失常的危险增加无关（HR，0.64；95%CI，0.18-2.27；P = .490）。结论既往 PVR 与 RVEF 变化无显著相关性，但与房性心律失常和感染性心内膜炎风险增加有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Revista espanola de cardiologia 医学-心血管系统

CiteScore

4.20

自引率

13.60%

发文量

257

审稿时长

28 days

期刊介绍： Revista Española de Cardiología, Revista bilingüe científica internacional, dedicada a las enfermedades cardiovasculares, es la publicación oficial de la Sociedad Española de Cardiología.