Nishi Katsuo, Eishi Kiyoyuki, Shibata Yoshisada, Amano Jun, Kaneko Tatsuo, Okabayashi Hitoshi, Takahara Yoshiharu, Takanashi Shuichiro, Tanemoto Kazuo, Yamaguchi Hiroki, Kawazoe Kohei
Department of Cardiovascular Surgery, Nagasaki University School of Medicine, Japan.
Ann Thorac Cardiovasc Surg. 2010 Dec;16(6):410-6.
To elucidate the effects of prosthetic valve sound on a patient's quality of life (QOL).
We compared the valve sounds of ATS, SJM, and Carbomedics (CM) based on assessments by 248 patients who underwent mechanical valve replacements from January 2000 to August 2003 at seven facilities in Japan. We used a self-administered questionnaire for evaluating patients' assessments of valve sounds and the Japanese version of SF-36 for measuring their health-related QOL.
With respect to the valve-sound level perceived immediately after surgery, we considered the ATS and SJM valves quieter than the CM valve, but others have considered the ATS valve quieter than the SJM and CM valves. Regarding the time when the valve sound stopped bothering patients, a significant difference was observed between the ATS and CM valves and between the SJM and CM valves. The logistic regression analysis on patients' perceptions of valve sounds indicated that the influences of age, gender, and valve position are significant. Furthermore, a survey with SF-36 indicated that a long valve sound will affect a patient's health-related QOL.
The present study suggested that the ATS valve surpassed the other two valves on the whole in audibility of valve sound and patient health-related QOL. However, further studies, including the ongoing prospective study, are necessary for a more comprehensive and accurate evaluation of the ATS valve.
阐明人工瓣膜声音对患者生活质量（QOL）的影响。
我们基于2000年1月至2003年8月期间在日本七家医疗机构接受机械瓣膜置换术的248例患者的评估，比较了ATS、SJM和Carbomedics（CM）瓣膜的声音。我们使用一份自我管理的问卷来评估患者对瓣膜声音的评价，并使用SF - 36日本版来测量他们与健康相关的生活质量。
关于术后即刻感知到的瓣膜声音水平，我们认为ATS和SJM瓣膜比CM瓣膜更安静，但其他人认为ATS瓣膜比SJM和CM瓣膜更安静。关于瓣膜声音不再困扰患者的时间，在ATS和CM瓣膜之间以及SJM和CM瓣膜之间观察到显著差异。对患者对瓣膜声音感知的逻辑回归分析表明，年龄、性别和瓣膜位置的影响是显著的。此外，一项使用SF - 36的调查表明，较长时间的瓣膜声音会影响患者与健康相关的生活质量。
本研究表明，在瓣膜声音的可听性和患者与健康相关的生活质量方面，ATS瓣膜总体上超过了其他两种瓣膜。然而，需要进一步的研究，包括正在进行的前瞻性研究，以便对ATS瓣膜进行更全面和准确的评估。
