术前左心室质量对主动脉瓣置换术后主动脉瓣反流预后的影响

IF 3.1 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Circulation Journal Pub Date : 2024-11-25 Epub Date: 2024-10-12 DOI:10.1253/circj.CJ-24-0464

Kohei Hachiro, Noriyuki Takashima, Kenichi Kamiya, Yasuo Kondo, Tomoaki Suzuki

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引用次数: 0

摘要

背景：我们确定了因主动脉瓣反流（AR）而接受主动脉瓣置换术（AVR）的患者发生重大不良心脑血管事件（MACCE）风险的左心室质量指数（LVMI）临界值，并研究了术前左心室重塑对术后长期预后的影响：我们回顾性分析了2002年1月至2022年12月期间在滋贺医科大学接受主动脉瓣反流手术的1,580例患者中263例患者的数据。接受者操作特征曲线显示，术前 LVMI 的临界值为 200 g/m2（曲线下面积=0.692）。在使用逆治疗概率加权法调整术前特征后，我们比较了术前 LVMI >200 g/m2 的患者（n=92）和术前 LVMI ≤200 g/m2 的患者（n=171）的术后结果。平均（±SD）随访时间为 6.9±5.1 年。术前 LVMI >200 g/m2 的患者 10 年后的 MACCE 率明显高于术前 LVMI ≤200 g/m2 的患者（25.6% vs. 13.5%；P=0.020）。在多变量 Cox 模型中，术前 LVMI >200 g/m2 与 MACCE 风险较高显著相关（危险比 2.356，P=0.006）：结论：在因 AR 而接受 AVR 的患者中，术前 LVMI >200 g/m2 与较高的 MACCE 发生率有关。

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Effect of Preoperative Left Ventricular Mass on Outcomes After Aortic Valve Replacement for Aortic Regurgitation.

Background: We determined the left ventricular mass index (LVMI) cut-off value for the risk of major adverse cardiac and cerebrovascular events (MACCE) in patients undergoing aortic valve replacement (AVR) for aortic regurgitation (AR) and investigated the effect of preoperative left ventricular remodeling on long-term outcomes postoperatively.

Methods and results: Of the 1,580 patients who underwent surgical AVR at Shiga University of Medical Science between January 2002 and December 2022, we retrospectively analyzed data for 263 patients who underwent surgery for AR. The receiver operating characteristic curve showed that the cut-off value of preoperative LVMI for the incidence of MACCE was 200 g/m²(area under the curve=0.692). We compared postoperative outcomes between patients with preoperative LVMI >200 g/m²(n=92) and those with preoperative LVMI ≤200 g/m²(n=171) after adjusting for preoperative characteristics using inverse probability of treatment weighting. The mean (±SD) follow-up period was 6.9±5.1 years. The rate of MACCE at 10 years was significantly higher in patients with preoperative LVMI >200 g/m²than in those with preoperative LVMI ≤200 g/m²(25.6% vs. 13.5%; P=0.020). In multivariable Cox models, preoperative LVMI >200 g/m²was significantly associated with a higher risk of MACCE (hazard ratio 2.356, P=0.006).

Conclusions: Preoperative LVMI >200 g/m²was associated with a higher rate of MACCE in patients undergoing AVR for AR.

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来源期刊

Circulation Journal 医学-心血管系统

CiteScore

5.80

自引率

12.10%

发文量

471

审稿时长

1.6 months

期刊介绍： Circulation publishes original research manuscripts, review articles, and other content related to cardiovascular health and disease, including observational studies, clinical trials, epidemiology, health services and outcomes studies, and advances in basic and translational research.