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严重主动脉瓣狭窄患者甲状腺素运载蛋白淀粉样变性心肌病行瓣膜置换术后:一项多中心研究。

Transthyretin amyloid cardiomyopathy in severe aortic stenosis submitted to valve replacement: a multicenter study.

机构信息

Cardiology Department, Hospital Senhora da Oliveira - Guimarães, Guimarães, 4835-044, Portugal.

Cardiology Department, Unidade Local de Saúde do Algarve - Hospital de Faro, Faro, 8000-386, Portugal.

出版信息

Future Cardiol. 2024;20(7-8):419-430. doi: 10.1080/14796678.2024.2393031. Epub 2024 Sep 4.

Abstract

To evaluate the prevalence of TTR amyloid cardiomyopathy (ATTR-CM) in severe aortic stenosis (SAS) patients, and to determine the independent predictors of major adverse events (MAE). 91 SAS patients >65 years with an interventricular septum thickness ≥12.5 mm were referred for aortic valve replacement (AVR). 99mTc-DPD scintigraphy was applied to diagnose ATTR-CM, in the absence of monoclonal protein. ATTR-CM was found in 11%. 78% of patients underwent AVR, but only 2 had ATTR-CM. There were no significant differences in the composite of all cause-mortality or cardiovascular hospitalizations. Lower left ventricle ejection fraction and not performing AVR were independent predictors of MAE. Not performing AVR was an independent predictor of MAE, regardless the ATTR-CM diagnosis.

摘要

评估严重主动脉瓣狭窄(SAS)患者转甲状腺素蛋白淀粉样心肌病(ATTR-CM)的患病率,并确定主要不良事件(MAE)的独立预测因素。91 名年龄>65 岁且室间隔厚度≥12.5mm 的 SAS 患者被转诊进行主动脉瓣置换术(AVR)。99mTc-DPD 闪烁显像术用于诊断无单克隆蛋白的 ATTR-CM。发现 11%的患者患有 ATTR-CM。78%的患者接受了 AVR,但只有 2 例患有 ATTR-CM。全因死亡率或心血管住院的复合终点无显著差异。较低的左心室射血分数和未行 AVR 是 MAE 的独立预测因素。无论是否诊断为 ATTR-CM,未行 AVR 都是 MAE 的独立预测因素。

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