Hamana Tomoyo, Iwasaki Masamichi, Shinke Toshiro, Kokawa Tatsuya, Fukuishi Yuta, Masaki Ryota, Odajima Susumu, Fujimoto Wataru, Kuroda Koji, Hatani Yutaka, Inoue Takumi, Okamoto Hiroshi, Okuda Masanori, Hayashi Takatoshi, Hirata Ken-Ichi
Department of Cardiology, Hyogo Prefectural Awaji Medical Center Sumoto Japan.
Division of Cardiovascular Medicine, Department of Internal Medicine, Showa University Graduate School of Medicine Tokyo Japan.
Circ Rep. 2020 Apr 9;2(6):322-329. doi: 10.1253/circrep.CR-19-0123.
The clinical frailty scale (CFS) predicts late mortality in patients undergoing transcatheter aortic valve replacement. We evaluated the CFS and other parameters associated with 1-year mortality after balloon aortic valvuloplasty (BAV). Between January 2013 and May 2018, 148 patients with severe aortic stenosis (AS) who underwent BAV at the present hospital were enrolled. We recorded pre-procedural CFS grade, baseline characteristics, echocardiographic, and hemodynamic parameters. To investigate the potential risk to patients before BAV, we evaluated the Society of Thoracic Surgeons (STS) score. After patients who underwent surgical aortic valve replacement, transcatheter aortic valve replacement or repeat BAV were excluded, we investigated 1-year survival. Of 127 patients, 41 (32.3%) died ≤1 year after BAV, 8 of whom (19.5% of all-cause deaths) had cardiac deaths. Higher grade of CFS and STS score significantly correlated with 1-year mortality. Severe frailty and the high operative risk group (CFS ≥7 and STS score ≥8.7%) had an extremely poor prognosis (1-year mortality, 81.2%). In this BAV cohort, severe frailty was a predictor of 1-year mortality in elderly patients with severe AS.
临床衰弱量表（CFS）可预测经导管主动脉瓣置换术患者的晚期死亡率。我们评估了CFS以及与球囊主动脉瓣成形术（BAV）后1年死亡率相关的其他参数。2013年1月至2018年5月，本医院148例接受BAV的重度主动脉瓣狭窄（AS）患者被纳入研究。我们记录了术前CFS分级、基线特征、超声心动图和血流动力学参数。为了调查BAV前患者的潜在风险，我们评估了胸外科医师协会（STS）评分。在排除接受外科主动脉瓣置换术、经导管主动脉瓣置换术或重复BAV的患者后，我们调查了1年生存率。127例患者中，41例（32.3%）在BAV后≤1年死亡，其中8例（占全因死亡的19.5%）死于心脏疾病。较高的CFS分级和STS评分与1年死亡率显著相关。严重衰弱和高手术风险组（CFS≥7且STS评分≥8.7%）的预后极差（1年死亡率为81.2%）。在这个BAV队列中，严重衰弱是老年重度AS患者1年死亡率的一个预测因素。
