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重度主动脉瓣反流患者行主动脉瓣置换术后左心室早期重塑的频率及其在每搏量≥97ml患者与每搏量<97ml患者之间的比较。

Frequency of early remodeling of left ventricle and its comparison between patients with stroke volume ≥97 Ml versus patients with stroke volume <97 Ml after aortic valve replacement for severe aortic regurgitation.

作者信息

Ali Rizvi Hafiz Muhammad Farhan, Khalid Zaigham Rasool, Baksh Allah, Raza Baig Mirza Ahmad

机构信息

Hafiz Muhammad Farhan Ali Rizvi, FCPS CS. Senior Registrar Cardiac Surgery, Pakistan.

Zaigham Rasool Khalid, FCPS CS. Senior Registrar Pediatric Cardiac Surgery, Pakistan.

出版信息

Pak J Med Sci. 2016 Nov-Dec;32(6):1360-1363. doi: 10.12669/pjms.326.11173.

DOI:10.12669/pjms.326.11173
PMID:28083026
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5216282/
Abstract

OBJECTIVES

To evaluate the frequency of early remodeling in patients of severe aortic regurgitation after aortic valve replacement and to see the incidence of early remodeling in patients with stroke volume >97 ml versus < 97 ml before aortic valve replacement.

METHOD

This was a prospective comparative study conducted from August 2013 to December 2014 in a tertiary care hospital. Fifty seven (57) patients of isolated chronic aortic regurgitation were included in this study. SPSS v23 was used for data analysis. Independent sample t-test was used for analysis of continuous variables and chi-square test for qualitative variables.

RESULTS

Out of fifty seven patients, early remodeling occurred in 34 (59.64%) patients after surgery. The mean pre-operative stroke volume of patient in whom remodeling occurred was 110.3+9.66 ml while mean pre-operative stroke volume of patients who did not undergo remodeling was 86.65+7.63 ml. There were 28 (82.4%) patients with stroke volume >97 ml in whom Remodeling occurred where as in patients with stroke volume <97 ml remodeling occurred only in 6 (17.6%) patients (p value 0.004). There was no in-hospital mortality.

CONCLUSION

There is an association between stroke volume and early LV remodeling after Aortic valve replacement. Stroke volume >97 ml is a good predictor of early LV remodeling.

摘要

目的

评估重度主动脉瓣关闭不全患者主动脉瓣置换术后早期重塑的发生率,并观察主动脉瓣置换术前每搏输出量>97ml与<97ml的患者早期重塑的发生率。

方法

这是一项于2013年8月至2014年12月在一家三级医疗中心进行的前瞻性对照研究。本研究纳入了57例单纯慢性主动脉瓣关闭不全患者。采用SPSS v23进行数据分析。连续变量分析采用独立样本t检验,定性变量分析采用卡方检验。

结果

57例患者中,34例(59.64%)术后发生早期重塑。发生重塑患者的术前平均每搏输出量为110.3+9.66ml,未发生重塑患者的术前平均每搏输出量为86.65+7.63ml。每搏输出量>97ml的患者中有28例(82.4%)发生重塑,而每搏输出量<97ml的患者中只有6例(17.6%)发生重塑(p值0.004)。院内无死亡病例。

结论

主动脉瓣置换术后每搏输出量与左心室早期重塑之间存在关联。每搏输出量>97ml是左心室早期重塑的良好预测指标。

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本文引用的文献

1
Preoperative ejection fraction determines early recovery of left ventricular end-diastolic dimension after aortic valve replacement for chronic severe aortic regurgitation.术前射血分数决定慢性重度主动脉瓣反流患者主动脉瓣置换术后左心室舒张末期内径的早期恢复情况。
J Surg Res. 2015 Jun 1;196(1):49-55. doi: 10.1016/j.jss.2015.02.069. Epub 2015 Mar 6.
2
Long term results and predictors of left ventricular function recovery after aortic valve replacement for chronic aortic regurgitation.慢性主动脉瓣反流患者主动脉瓣置换术后左心室功能恢复的长期结果及预测因素
Ann Thorac Cardiovasc Surg. 2015;21(4):388-95. doi: 10.5761/atcs.oa.14-00295. Epub 2015 Feb 16.
3
Usefulness of preoperative stroke volume as strong predictor of left ventricular remodeling and outcomes after aortic valve replacement in patients with severe pure aortic regurgitation.术前每搏量作为严重单纯主动脉瓣反流患者主动脉瓣置换术后左心室重构和结局的强预测因子的有用性。
Am J Cardiol. 2011 Oct 1;108(7):1008-13. doi: 10.1016/j.amjcard.2011.05.035. Epub 2011 Jul 27.
4
CME: long-term outcome in asymptomatic patients with severe aortic regurgitation, normal left ventricular ejection fraction, and severe left ventricular dilatation.继续医学教育:无症状严重主动脉瓣反流、左心室射血分数正常及严重左心室扩张患者的长期预后
Echocardiography. 2010 Sep;27(8):915-22. doi: 10.1111/j.1540-8175.2010.01193.x.
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Survival benefit of aortic valve replacement in older patients with asymptomatic chronic severe aortic regurgitation.主动脉瓣置换术治疗无症状慢性重度主动脉瓣反流老年患者的生存获益。
Ann Thorac Surg. 2010 Mar;89(3):731-7. doi: 10.1016/j.athoracsur.2009.12.008.
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Preoperative systolic strain rate predicts postoperative left ventricular dysfunction in patients with chronic aortic regurgitation.术前收缩期应变率可预测慢性主动脉瓣反流患者的术后左心室功能障碍。
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