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在大动脉转位合并体循环右心室的成年人中进行的SERVE试验中的稳定纵向生活质量

Stable Longitudinal Quality of Life in the SERVE Trial Among Adults With Transposition of the Great Arteries and a Systemic Right Ventricle.

作者信息

Castiglione Alessandro, Schwerzmann Markus, Bouchardy Judith, Buechel Ronny Ralf, Engel Reto, Freese Michael, Gabriel Harald, Greutmann Matthias, Heg Dik, Mueller Christian, Possner Mathias, Ruperti-Repilado Francisco Javier, Rutz Tobias, Schwitter Jurg, Thomet Corina, Tobler Daniel, Wilhelm Matthias, Wustmann Kerstin, Schwitz Fabienne

机构信息

Department of Cardiology, Center for Congenital Heart Diseases, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.

出版信息

CJC Pediatr Congenit Heart Dis. 2024 Dec 12;4(2):81-91. doi: 10.1016/j.cjcpc.2024.12.001. eCollection 2025 Apr.

Abstract

BACKGROUND

Adults with a transposition anatomy and a systemic right ventricle (RV) face long-term complications that may impact their quality of life (QoL). Few data are available regarding the QoL in this patient group and its evolution over time.

METHODS

This study was performed in the SERVE trial's (identifier: NCT03049540) prospective cohort of patients (n = 100) with congenitally corrected transposition of the great arteries (TGA) or dextro-TGA after the atrial switch procedure and a longitudinal follow-up of 3 years. We aimed to describe the longitudinal QoL levels and their predictors. QoL was assessed using the Linear Analog Scale. QoL parameters were collected at baseline, after 12 months, and after 36 months, together with clinical parameters and a questionnaire assessing general self-efficacy (GSE).

RESULTS

The mean QoL on the Linear Analog Scale was 79.1 ± 13.6 at baseline, 75.5 ± 14.8 at 1 year, and 79.2 ± 13.6 at 3-year follow-up ( = 0.900). No significant differences in QoL were observed between congenitally corrected TGA or dextro-TGA patients. Cardiopulmonary exercise testing maximum work rate and maximum oxygen uptake, New York Heart Association class, end-diastolic RV volumes, N-terminal pro-B-type natriuretic peptide concentration, and GSE showed significant correlations with QoL levels. Multivariable regression analysis identified GSE value and New York Heart Association class (  = 0.283, < 0.001) as independent predictors of QoL at baseline.

CONCLUSIONS

Patients with a systemic RV reported a stable good QoL during 3 years of follow-up. Exercise capacity and self-efficacy were the only independent predictors of QoL.

CLINICAL TRIAL REGISTRATION

NCT03049540.

摘要

背景

具有大动脉转位解剖结构和体循环右心室(RV)的成年人面临可能影响其生活质量(QoL)的长期并发症。关于该患者群体的生活质量及其随时间的演变,可用数据很少。

方法

本研究在SERVE试验(标识符:NCT03049540)的前瞻性队列中进行,该队列有100例患有先天性矫正型大动脉转位(TGA)或心房调转术后右旋TGA的患者,并进行了3年的纵向随访。我们旨在描述纵向生活质量水平及其预测因素。使用线性模拟量表评估生活质量。在基线、12个月后和36个月后收集生活质量参数,同时收集临床参数和一份评估一般自我效能感(GSE)的问卷。

结果

线性模拟量表上的平均生活质量在基线时为79.1±13.6,1年时为75.5±14.8,3年随访时为79.2±13.6(P = 0.900)。先天性矫正型TGA或右旋TGA患者之间未观察到生活质量的显著差异。心肺运动试验的最大工作率和最大摄氧量、纽约心脏协会分级、舒张末期右心室容积、N末端前B型利钠肽浓度和GSE与生活质量水平显著相关。多变量回归分析确定GSE值和纽约心脏协会分级(β = 0.283,P < 0.001)为基线时生活质量的独立预测因素。

结论

体循环右心室患者在3年随访期间报告生活质量稳定良好。运动能力和自我效能感是生活质量的唯一独立预测因素。

临床试验注册

NCT03049540。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46b4/12131024/c085e627e7f4/ga1.jpg

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