早期左室射血分数改善对经导管主动脉瓣置换术后1年临床结果及其预测因素的影响

IF 1.6 4区医学 Q2 SURGERY

Surgery Today Pub Date : 2025-05-03 DOI:10.1007/s00595-025-03036-8

Ikuko Shibasaki, Yusuke Takei, Suguru Hirose, Michiaki Tokura, Masahiro Tezuka, Shohei Yokoyama, Ryujiro Suzuki, Riichi Nishikawa, Shu Inami, Yasuo Haruyama, Shigeru Toyoda, Hirotsugu Fukuda

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引用次数: 0

摘要

目的：评估严重主动脉瓣狭窄（AS）术前左心室射血分数（LVEF）患者1年的临床结局（全因死亡率、心力衰竭再住院及其综合）方法：回顾性分析44例接受TAVR的患者，将其分为R组（LVEF改善≥10%，n = 25）和n组（结果：患者平均年龄为84.8±4.8岁，男性40.9%）。tavr后，56.8%的患者LVEF改善≥10%（平均增加16.7±6.1%）。两组之间的1年死亡率相似（p = 0.383），而N组的综合终点往往更高（0.4% vs. 21.1%, p = 0.072）。主动脉瓣峰值流速是唯一有意义的预测因子(OR = 0.255, p = 0.048；截止：4.45 m/s，灵敏度0.840；特异性,0.684)。结论：严重AS患者术前LVEF为

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Impact of an improvement in the early left ventricular ejection fraction on the 1-year clinical outcomes and its predictors after transcatheter aortic valve replacement.

Purpose: We evaluated the 1-year clinical outcomes (all-cause mortality, heart failure rehospitalization, and their composite) in patients with severe aortic stenosis (AS) and a preoperative left ventricular ejection fraction (LVEF) < 50% who underwent transcatheter aortic valve replacement (TAVR), and examined the baseline factors predicting ≥ 10% early LVEF improvement.

Methods: We retrospectively analyzed 44 patients who underwent TAVR and divided them into Group R (≥ 10% LVEF improvement, n = 25) or Group N (< 10% improvement, n = 19). A Kaplan-Meier analysis was used to assess the survival rates, and multivariable logistic regression was applied to identify the predictors of LVEF improvement.

Results: The mean patient age was 84.8 ± 4.8 years, and 40.9% were male. Post-TAVR, 56.8% of patients showed ≥ 10% LVEF improvement (mean increase: 16.7 ± 6.1%). The one-year mortality was similar between the groups (p = 0.383), whereas the composite endpoint tended to be higher in Group N (0.4% vs. 21.1%, p = 0.072). The peak aortic valve velocity was the only significant predictor (OR = 0.255, p = 0.048; cutoff: 4.45 m/s, sensitivity, 0.840; specificity, 0.684).

Conclusion: In patients with severe AS and a preoperative LVEF of < 50%, 56.8% demonstrated a significant early LVEF improvement post-TAVR. Patients with a ≥ 10% improvement had a significantly lower 1-year mortality rate.

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来源期刊

Surgery Today 医学-外科

CiteScore

4.90

自引率

4.00%

发文量

208

审稿时长

1 months

期刊介绍： Surgery Today is the official journal of the Japan Surgical Society. The main purpose of the journal is to provide a place for the publication of high-quality papers documenting recent advances and new developments in all fields of surgery, both clinical and experimental. The journal welcomes original papers, review articles, and short communications, as well as short technical reports("How to do it"). The "How to do it" section will includes short articles on methods or techniques recommended for practical surgery. Papers submitted to the journal are reviewed by an international editorial board. Field of interest: All fields of surgery.