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急性心肌梗死后室间隔破裂的临床转归:一项回顾性观察性试验。

The Clinical Outcomes of Ventricular Septal Rupture Secondary to Acute Myocardial Infarction: A Retrospective, Observational Trial.

机构信息

Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China.

出版信息

J Interv Cardiol. 2021 Dec 14;2021:3900269. doi: 10.1155/2021/3900269. eCollection 2021.

Abstract

BACKGROUND

Ventricular septal rupture (VSR) is a severe mechanical complication secondary to acute myocardial infarction (AMI) with a dreadful prognosis. The goal of our study was to evaluate the mortality and to identify the predictors of mortality for this population.

METHODS

From June 2012 to July 2021, patients with VSR secondary to AMI were initially screened for eligibility in this study. The potential risk predictors were determined using appropriate logistic regression models.

RESULTS

In this retrospective study, a total of 50 cases were included, and 14 patients survived and got discharged successfully. Univariable analyses indicated that the heart rate (HR), white blood cell (WBC) count, neutrophils count, serum glucose, serum creatinine, serum lactic acid, and the closure of rupture were significantly associated with mortality among these special populations.

CONCLUSION

This study found that such high mortality in patients with VSR after AMI was significantly correlated with these risk factors representing sympathetic excitation and large infarct size. Coronary revascularization combined with the closure of rupture might be helpful in improving their prognosis.

摘要

背景

室间隔破裂(VSR)是急性心肌梗死(AMI)的严重机械并发症,预后极差。我们的研究目的是评估该人群的死亡率并确定其死亡预测因素。

方法

从 2012 年 6 月至 2021 年 7 月,对 AMI 继发 VSR 的患者进行了初步筛选,以评估其是否符合纳入标准。使用适当的逻辑回归模型确定潜在的风险预测因素。

结果

在这项回顾性研究中,共纳入 50 例患者,其中 14 例患者存活并成功出院。单变量分析表明,心率(HR)、白细胞(WBC)计数、中性粒细胞计数、血糖、血肌酐、血乳酸和破裂的闭合与该特殊人群的死亡率显著相关。

结论

本研究发现,AMI 后 VSR 患者的高死亡率与代表交感兴奋和大面积梗死的这些危险因素显著相关。冠状动脉血运重建联合破裂闭合可能有助于改善其预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e102/8692018/c70ee6f046c9/JITC2021-3900269.001.jpg

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