左心耳自发性超声造影是否会增加左心耳关闭后血栓栓塞的风险？其对器械相关血栓形成和动脉血栓栓塞事件影响的回顾性研究

IF 3.4 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Therapeutics Pub Date : 2025-04-11 DOI:10.1155/cdr/1849432

Kandi Zhang, Hanwen Yu, Yihua Lu, Peng Zhang, Dongsheng Liu, Jianpeng Huang, Jing Zhou, Yiqian Yuan, Zongqi Zhang, Qingyong Zhang, Qing He, Junfeng Zhang

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引用次数: 0

摘要

背景：左心房附件关闭（LAAC）可以预防非瓣膜性心房颤动（AF）的动脉血栓栓塞事件（ATEs）。自发性回声造影（SEC）是左心耳（LAA）血栓形成的独立危险因素；然而，对于行LAAC的房颤患者术前SEC与器械相关血栓形成（DRT）或ATEs风险增加之间的关系知之甚少。方法：本回顾性研究集中于成功行LAAC手术的非瓣膜性房颤患者。经食管超声心动图（TEE）评估术前LAA状态。LAA 0-2级的SEC定义为LAASEC−，3-4级或先前诊断的LAA血栓形成定义为LAASEC+。结果：共有519例AF患者（LAASEC -组432例，LAASEC+组87例）行LAAC。在1年随访中，LAASEC -组和LAASEC+组的DRT发生率（2.5 vs. 3.8%, p = 0.636）、ATEs发生率（0.5 vs. 0%, p = 0.525）和全因死亡率（2.1% vs. 2.3%, p = 0.899）无显著差异。而LAASEC+组菜花型LAA比例较高，且≥3叶。结论：LAAC术后1年内房颤患者DRT或ATEs的发生率与术前LAA血栓形成或LAASEC的差异无关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Does Spontaneous Echo Contrast in the Left Atrial Appendage Increase Thromboembolism Risk After Left Atrial Appendage Closure? A Retrospective Study on Its Impact on Device-Related Thrombosis and Arterial Thromboembolic Events

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Background: Left atrial appendage closure (LAAC) prevents arterial thromboembolic events (ATEs) in nonvalvular atrial fibrillation (AF). Spontaneous echo contrast (SEC) is an independent risk factor for left atrial appendage (LAA) thrombosis; however, there is little knowledge about the relationship between preoperative SEC and the increased risk of device-related thrombosis (DRT) or ATEs in patients with AF who have undergone LAAC.

Methods: This retrospective study focused on patients with nonvalvular AF who successfully underwent LAAC surgery. Transesophageal echocardiography (TEE) was used to assess preoperative LAA status. SEC in LAA Grades 0–2 was defined as LAASEC−, and Grades 3–4 or previously diagnosed LAA thrombus formation as LAASEC+.

Results: A total of 519 AF patients (432 in LAASEC− group and 87 in LAASEC+ group) who underwent LAAC were included. At the 1-year follow-up, there was no significant difference in the incidence of DRT (2.5 vs. 3.8%, p = 0.636), ATEs (0.5 vs. 0%, p = 0.525), and all-cause mortality (2.1% vs. 2.3%, p = 0.899) between the LAASEC− group and the LAASEC+ group. However, the LAASEC+ group had higher proportions of cauliflower-type LAA and ≥ 3 lobes.

Conclusions: The difference in preoperative LAA thrombosis or LAASEC was not related to the incidence of DRT or ATEs in AF patients within 1 year after LAAC.

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来源期刊

Cardiovascular Therapeutics 医学-心血管系统

CiteScore

5.60

自引率

0.00%

发文量

审稿时长

6 months

期刊介绍： Cardiovascular Therapeutics (formerly Cardiovascular Drug Reviews) is a peer-reviewed, Open Access journal that publishes original research and review articles focusing on cardiovascular and clinical pharmacology, as well as clinical trials of new cardiovascular therapies. Articles on translational research, pharmacogenomics and personalized medicine, device, gene and cell therapies, and pharmacoepidemiology are also encouraged. Subject areas include (but are by no means limited to): Acute coronary syndrome Arrhythmias Atherosclerosis Basic cardiac electrophysiology Cardiac catheterization Cardiac remodeling Coagulation and thrombosis Diabetic cardiovascular disease Heart failure (systolic HF, HFrEF, diastolic HF, HFpEF) Hyperlipidemia Hypertension Ischemic heart disease Vascular biology Ventricular assist devices Molecular cardio-biology Myocardial regeneration Lipoprotein metabolism Radial artery access Percutaneous coronary intervention Transcatheter aortic and mitral valve replacement.