Relationship between Complete Revascularization and Survival after Post-Infarction Ventricular Septal Rupture.

IF 0.5 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
Ata Firuzi, Masood Shekarchizadeh, Mona Yadollahi, Arezoo Mohamadifar, Ehsan Ferasati, Mansoureh Shekarchizadeh-Esfahani
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引用次数: 0

Abstract

Introduction: A well-known and fatal complication of myocardial infarction (MI) is post-infarction ventricular septal rupture (VSR). The benefits and risks associated with coronary angiography and subsequent coronary artery bypass grafting in these patients have sparked controversy. The aim of this study was to determine the outcome of revascularization following MI.

Method: Patients aged between 55 and 78 years were considered for the post-infarction ventricular septal rupture from 2011 to 2017. Factors such as age, sex, anthropometric measurements, systolic and diastolic blood pressure (SBP and DBP), and biochemical parameters like CPK-MB, cholesterol, low-density lipoprotein, high-density lipoprotein, and triglycerides were measured using standard methods.The estimated Glomerular Filtration Rate (eGFR), a measure of kidney function, was also determined. Additionally, coronary angiographic factors including ECG changes, left ventricular (LV) systolic function, right ventricular (RV) function, Pulmonary Artery Pressure (PAP), proximal coronary lesions in VSR, systolic PAP, Right Atrial Pressure (RAP), and mortality rate were determined.

Results: The study enrolled a total of 81 patients who had been surgically treated for post-infarction VSR. These patients were divided into two groups: survivors (n=35) and non-survivors (N=41). The mean systolic and diastolic blood pressure was higher in the survivor group (115.3 ± 18.7 vs. 96.3 ± 25.3 and 74.6 ± 12.2 vs. 61.2 ± 19.0, P=0.001). PCI was performed in 2.9% of survivors and 9.8% of non-survivors. Angiographic data revealed that 17 (33%) and 33 (63%) patients had single and multiple coronary artery diseases, respectively. CPK-MB levels were significantly higher in the non-survivors group (P<0.05). Echocardiographic findings, including LV ejection fraction, RV ejection fraction, systolic PAP, and the anatomic location of VSR, did not significantly differ between survivors and non-survivors.

Conclusion: Based on these findings, it is recommended to avoid complete revascularization during surgical repair of post-infarction ventricular septal rupture, as it would not improve the outcome.

心梗后室间隔破裂后完全血管再通与存活率之间的关系
导言:众所周知,心肌梗死(MI)的致命并发症是梗死后室间隔破裂(VSR)。对这些患者进行冠状动脉造影术和随后的冠状动脉旁路移植术的益处和风险引发了争议。本研究旨在确定心肌梗死后进行血管重建的结果:方法:2011 年至 2017 年期间,年龄在 55 岁至 78 岁之间的心肌梗死后室间隔破裂患者被纳入考虑范围。采用标准方法测量了年龄、性别、人体测量、收缩压和舒张压(SBP和DBP)等因素,以及CPK-MB、胆固醇、低密度脂蛋白、高密度脂蛋白和甘油三酯等生化指标,还测定了衡量肾功能的估计肾小球滤过率(eGFR)。此外,还测定了冠状动脉造影因素,包括心电图变化、左室(LV)收缩功能、右室(RV)功能、肺动脉压(PAP)、VSR 中的冠状动脉近端病变、收缩压(PAP)、右房压(RAP)和死亡率:该研究共纳入了 81 名因心梗后 VSR 而接受手术治疗的患者。这些患者被分为两组:幸存者(35 人)和非幸存者(41 人)。幸存者组的平均收缩压和舒张压较高(115.3 ± 18.7 vs. 96.3 ± 25.3 和 74.6 ± 12.2 vs. 61.2 ± 19.0,P=0.001)。2.9%的幸存者和9.8%的非幸存者进行了PCI手术。血管造影数据显示,分别有 17 名(33%)和 33 名(63%)患者患有单支和多支冠状动脉疾病。非幸存者组的 CPK-MB 水平明显较高:根据上述研究结果,建议在对梗死后室间隔破裂进行手术修复时避免进行完全血管再通,因为这样做并不会改善预后。
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来源期刊
ARYA Atherosclerosis
ARYA Atherosclerosis CARDIAC & CARDIOVASCULAR SYSTEMS-
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审稿时长
18 weeks
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