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NEJM:经皮二尖瓣修补术不能改善慢性心力衰竭伴左室射血分数降低患者预后

2018-12-13 zhangfan MedSci原创

研究认为,经皮二尖瓣修补术对慢性心力衰竭伴左室射血分数降低的患者无显著疗效

临床发现慢性心力衰竭伴左心室射血分数降低的患者中,严重继发性二尖瓣反流与预后不良有关。近日研究人员考察了经皮二尖瓣修补术对改善上述患者症状的疗效。

严重继发性二尖瓣返流,伴LVEF 15-40%的心衰患者参与研究,在药物治疗的基础上随机接受经皮二尖瓣修补术(n=152)或对照(n=152),研究的主要终点为12个月内全因死亡或计划外心衰住院。

12个月,手术组主要终点事件发生率为54.6%,对照组为51.3%(OR=1.16),全因死亡率分别为24.3%和22.4%,计划外心衰住院率为48.7%和47.4%。

研究认为,经皮二尖瓣修补术对慢性心力衰竭伴左室射血分数降低的患者无显著疗效。

原始出处:

Jean-Franois Obadia et al. Percutaneous Repair or Medical Treatment for Secondary Mitral Regurgitation.N Engl J Med, December 13, 2018.

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    2018-12-14 wwzzly
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    2018-12-14 龙胆草

    学习谢谢分享

    0

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    2018-12-13 topnew

    难道是筛选病人,有问题,怎么会无效?

    0

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心力衰竭是指心室充盈或射血的任何结构或功能受损所导致的一种临床综合征,主要表现为限制运动耐量下降(呼吸困难、疲乏)和液体潴留(肺淤血、体循环淤血及外周水肿)。由于心室充盈及射血功能是心脏的主要功能,其功能的好坏将直接影响患者的预后。因此,对心脏功能进行评估分级有着很重要的临床指导意义。本文接下来将为大家介绍临床上常用的心功能评估方法。

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心力衰竭(简称“心衰”)是各种心脏疾病的严重表现或晚期阶段,死亡率和再住院率居高不下。流行病学调查显示,我国35~74岁成人心衰患病率为0.9%[1]。随着人口老龄化加剧,以及医疗水平的提高使心脏疾病患者生存期延长,导致我国心衰患病率呈持续升高趋势。根据近年来心衰领域的最新研究证据,参考最新欧美心衰指南,结合我国国情及临床实践,“中国心力衰竭诊断和治疗指南2018”基于2014版中国心衰指南进

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