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JACC:经导管主动脉瓣置换术后传导异常患者的死亡率和心衰住院率

2019-01-08 xiangting MedSci原创

TAVR后的新发BBB和新PPM很常见。新发BBB与早晚期全因死亡率升高相关,而新PPM与晚期全因死亡率相关。

这项研究目的是评估经导管主动脉瓣置换术(TAVR)后新发束支传导阻滞(BBB)和/或永久起搏器植入(PPM)患者的死亡率和再住院率。

既往研究关于TAVR后新发BBB或新植入PPM临床影响的结果并不一致。

研究纳入2007年至2017年间接受TAVR治疗、并无未术前BBB或PPM的816例连续性患者,对这些患者随访5年或直至2017年9月提取数据。通过国家登记获得生命状况和住院治疗的数据。

TAVR后30天内,分别有247例(30.3%)和132例(16.2%)患者出现无PPM的新发BBB和植入新PPM,其余437例患者(53.6%)无传导异常。中位随访时间为2.5年(四分位间距:1.0至4.9年)。与无传导异常的患者相比,新发BBB的1年全因死亡率升高(风险比[HR]:2.80;95%置信区间[CI]:1.18至3.67),但新植入PPM患者的死亡率无升高(HR:1.64; 95%CI:0.72至3.74)。与无传导异常的患者相比,新发BBB患者(HR:1.79; 95%CI:1.24至2.59)和新植入PPM患者(HR:1.58; 95%CI:1.01至2.46)的晚期全因死亡率风险均升高(TAVR后≥1年)。随访期间,新发BBB患者(HR:1.47; 95%CI:1.02至2.12)和新植入PPM患者(HR:1.66; 95%CI:1.09至2.54)出现心衰住院和左室射血分数降低的风险升高。

TAVR后的新发BBB和新PPM很常见。新发BBB与早晚期全因死亡率升高相关,而新PPM与晚期全因死亡率相关。此外,新发BBB和新PPM均增加了心衰住院的风险。

原始出处:

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    2019-11-19 hbwxf
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    2019-11-11 yxch48
  4. 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  5. 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  6. 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Jan 10 02:13:00 CST 2019, time=2019-01-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1576674, encodeId=30a715e66745a, content=<a href='/topic/show?id=48fee966468' target=_blank style='color:#2F92EE;'>#置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79664, encryptionId=48fee966468, topicName=置换术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=054816326830, createdName=ms117281293605716, createdTime=Thu Jan 10 02:13:00 CST 2019, time=2019-01-10, status=1, ipAttribution=)]
  8. [GetPortalCommentsPageByObjectIdResponse(id=1854274, encodeId=ff5818542e47c, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Tue Nov 19 06:13:00 CST 2019, time=2019-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2055869, encodeId=fa182055869b7, content=<a href='/topic/show?id=074651931a0' target=_blank style='color:#2F92EE;'>#心衰住院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51931, encryptionId=074651931a0, topicName=心衰住院)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=460849, createdName=ymljack, createdTime=Thu May 23 15:13:00 CST 2019, time=2019-05-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1742565, encodeId=2a981e42565a9, content=<a href='/topic/show?id=39cae96626f' target=_blank style='color:#2F92EE;'>#置换#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79662, encryptionId=39cae96626f, topicName=置换)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3a7c35056336, createdName=yxch48, createdTime=Mon Nov 11 04:13:00 CST 2019, time=2019-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1326088, encodeId=6d87132608860, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Thu Jan 10 02:13:00 CST 2019, time=2019-01-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1332605, encodeId=557f13326058f, content=<a href='/topic/show?id=1dd6231822d' target=_blank style='color:#2F92EE;'>#主动脉瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23182, encryptionId=1dd6231822d, topicName=主动脉瓣)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc4b2500077, createdName=hittouch, createdTime=Thu Jan 10 02:13:00 CST 2019, time=2019-01-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1367154, encodeId=b11c136e1542c, content=<a href='/topic/show?id=b6222320322' target=_blank style='color:#2F92EE;'>#主动脉瓣置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23203, encryptionId=b6222320322, topicName=主动脉瓣置换术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0b24249, createdName=medsci246, createdTime=Thu Jan 10 02:13:00 CST 2019, time=2019-01-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415445, encodeId=be5e1415445bc, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Thu Jan 10 02:13:00 CST 2019, time=2019-01-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1510186, encodeId=0e1f15101860f, content=<a href='/topic/show?id=e9bce8254ef' target=_blank style='color:#2F92EE;'>#经导管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78254, encryptionId=e9bce8254ef, topicName=经导管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=93e010191378, createdName=lsj631, createdTime=Thu Jan 10 02:13:00 CST 2019, time=2019-01-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1536555, encodeId=073d153655504, content=<a href='/topic/show?id=a894e826546' target=_blank style='color:#2F92EE;'>#经导管主动脉瓣置换#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78265, encryptionId=a894e826546, topicName=经导管主动脉瓣置换)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b38112697961, createdName=yytms, createdTime=Thu Jan 10 02:13:00 CST 2019, time=2019-01-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1576674, encodeId=30a715e66745a, content=<a href='/topic/show?id=48fee966468' target=_blank style='color:#2F92EE;'>#置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79664, encryptionId=48fee966468, topicName=置换术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=054816326830, createdName=ms117281293605716, createdTime=Thu Jan 10 02:13:00 CST 2019, time=2019-01-10, status=1, ipAttribution=)]
    2019-01-10 lsj631
  9. 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objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23203, encryptionId=b6222320322, topicName=主动脉瓣置换术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0b24249, createdName=medsci246, createdTime=Thu Jan 10 02:13:00 CST 2019, time=2019-01-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415445, encodeId=be5e1415445bc, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Thu Jan 10 02:13:00 CST 2019, time=2019-01-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1510186, 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  10. 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