肺动脉高压对二尖瓣导管边缘到边缘修复术后短期和长期预后的影响：一项荟萃分析。

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Revascularization Medicine Pub Date : 2025-09-01 DOI:10.1016/j.carrev.2024.12.012

Sivaram Neppala , Himaja Dutt Chigurupati , Ayman Fath , Gowthami Sai Kogilathota Jagirdhar , Harigopal Sandhyavenu , Jeffery Bolte , Abdullah Naveed Muhammad , Yasar Sattar , Rupak Desai , Ralph A. Defronzo , Timir K. Paul , Anand Prasad

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引用次数: 0

摘要

背景：肺动脉高压（pHTN）与二尖瓣经导管边缘到边缘修复（TEER）后发病率和死亡率增加有关，但其相关性尚不确定。本研究旨在评估pHTN对TEER后心血管结局的影响。方法：我们检索PubMed、Scopus和Medline，以确定报告pHTN患者TEER后结果的研究。利用随机效应模型，我们确定了肺动脉收缩压（PASP >50 mmHg）患者与无PASP患者临床结果的合并优势比（OR）。结果：我们纳入了7项研究，共27,965例患者。平均年龄79.9（±5.2）岁；53%为男性，75%为纽约心脏协会（NYHA） iii /IV级，中位随访360天。重度pHTN患者的院内全因死亡率较高（OR: 1.99, 95% CI: 1.69-2.34, p）。结论：重度pHTN与二尖瓣TEER患者的全因死亡率、MACE和心力衰竭再住院率升高相关。有必要进行前瞻性试验来验证研究结果，并确定早期干预是否能改善临床结果。

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Impact of pulmonary hypertension on short and long-term outcome after mitral transcatheter edge-to-edge repair: A meta-analysis

Background

Pulmonary hypertension (pHTN) has been associated with increased morbidity and mortality after mitral Transcatheter Edge-to-Edge Repair (TEER), but the association remains uncertain. This study aims to evaluate the impact of pHTN on cardiovascular outcomes following TEER.

Methods

We searched PubMed, Scopus, and Medline to identify studies reporting outcomes after TEER in individuals with pHTN. Utilizing a random-effects model, we ascertained a pooled odds ratio (OR) of clinical outcomes in patients with pulmonary artery systolic pressure (PASP >50 mmHg) vs. without (PASP <50 mmHg) severe pHTN.

Results

We included seven studies with 27,965 patients. The mean age was 79.9 (±5.2) years; 53 % were male, and 75 % were New York Heart Association (NYHA) class-III/IV with a median follow-up of 360 days. Patients with severe pHTN had higher odds of in-hospital all-cause mortality (OR: 1.99, 95 % CI: 1.69–2.34, p < 0.00001) and Major adverse cardiovascular events (MACE) (OR: 1.38, 95 % CI: 1.22–1.56, p < 0.00001) compared to patients without severe pHTN.

Conclusions

Severe pHTN is associated with increased risks of all-cause mortality, MACE, and higher heart failure rehospitalizations in patients undergoing mitral TEER. Prospective trials are necessary to validate the findings and determine if early intervention improves clinical outcomes.

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来源期刊

Cardiovascular Revascularization Medicine CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

3.30

自引率

5.90%

发文量

687

审稿时长

36 days

期刊介绍： Cardiovascular Revascularization Medicine (CRM) is an international and multidisciplinary journal that publishes original laboratory and clinical investigations related to revascularization therapies in cardiovascular medicine. Cardiovascular Revascularization Medicine publishes articles related to preclinical work and molecular interventions, including angiogenesis, cell therapy, pharmacological interventions, restenosis management, and prevention, including experiments conducted in human subjects, in laboratory animals, and in vitro. Specific areas of interest include percutaneous angioplasty in coronary and peripheral arteries, intervention in structural heart disease, cardiovascular surgery, etc.