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直接经皮冠状动脉介入治疗后左心室舒张末期压力的改善及其对患者恢复的影响。

Improvement in LV end-diastolic pressure after primary PCI and its impact on patients' recovery.

作者信息

Bhatti Usman Hanif, Naseeb Khalid, Khan Muhammad Nauman, Mal Vashu, Baqai Muhammad Asad, Karim Musa, Khan Muhammad Asher, Saghir Tahir

机构信息

Post Fellow Interventional Cardiology.

Associate Professor of Cardiology.

出版信息

Br J Cardiol. 2023 Nov 29;30(4):43. doi: 10.5837/bjc.2023.043. eCollection 2023.

Abstract

In this study, we evaluated the change in left ventricular end-diastolic pressure (LVEDP) after primary percutaneous coronary intervention (PCI) and its impact on in-hospital outcomes and 30-day and three-month quality of life (SAQ-7), ejection fraction (EF), and major adverse cardiovascular events (MACE). LVEDP ≥19 mmHg was taken as elevated LVEDP. In a sample of 318 patients, 18.9% (n=60) were females and mean age was 55.7 ± 10.52 years. Post-procedure elevated LVEDP was observed in 20.8% (n=66) with a mean reduction of 1.65 ± 4.35 mmHg. LVEDP declined in 39% (n=124) and increased in 10.7% (n=34). In-hospital mortality rate (9.1% 2.4%, p=0.011), 30-day MACE (9.1% 4.0%), and three-month MACE (21.2% 5.6%) were found to be significantly higher among patients with elevated LVEDP, respectively. Elevated LVEDP was found to be associated with a reduced SAQ-7 score (89.84 ± 8.09 92.29 ± 3.03, p<0.001) and reduced (25-40%) EF (55.6% 22.6%) at three-month follow-up. LVEDP declined acutely in a significant number of patients after primary PCI. Post- procedure elevated LVEDP was found to be associated with poor quality of life and an increased risk of immediate and short-term MACE.

摘要

在本研究中,我们评估了直接经皮冠状动脉介入治疗(PCI)后左心室舒张末期压力(LVEDP)的变化及其对住院结局、30天和3个月生活质量(SAQ-7)、射血分数(EF)和主要不良心血管事件(MACE)的影响。LVEDP≥19 mmHg被视为LVEDP升高。在318例患者样本中,18.9%(n = 60)为女性,平均年龄为55.7±10.52岁。术后观察到20.8%(n = 66)的患者LVEDP升高,平均降低1.65±4.35 mmHg。39%(n = 124)的患者LVEDP下降,10.7%(n = 34)的患者LVEDP升高。LVEDP升高的患者住院死亡率(9.1%对2.4%,p = 0.011)、30天MACE(9.1%对4.0%)和3个月MACE(21.2%对5.6%)分别显著更高。发现LVEDP升高与3个月随访时SAQ-7评分降低(89.84±8.09对92.29±3.03,p<0.001)和EF降低(25 - 40%)(55.6%对22.6%)相关。直接PCI后相当数量的患者LVEDP急性下降。术后LVEDP升高与生活质量差以及近期和短期MACE风险增加相关。

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