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JACC:经导管二尖瓣置换术的可行性研究

2018-01-02 MedSci MedSci原创

经导管二尖瓣置换术(TMVR)是一种具有潜力的治疗重度二尖瓣反流病人的手术方法,然而其可行性尚有待明确。本研究在14个临床研究中心招募了50例重度二尖瓣反流伴高危因素的患者(平均年龄为73 ± 9岁,男性占58%),并对所有参与者实施了经导管二尖瓣置换术。患者术前的胸外科协会平均评分为6.4 ± 5.5%,86%患者的纽约心功能评级为III或IV级,平均左室射血分数为43 ± 12%。人工瓣膜成功

经导管二尖瓣置换术(TMVR)是一种具有潜力的治疗重度二尖瓣反流病人的手术方法,然而其可行性尚有待明确。本研究在14个临床研究中心招募了50例重度二尖瓣反流伴高危因素的患者(平均年龄为73 ± 9岁,男性占58%),并对所有参与者实施了经导管二尖瓣置换术。患者术前的胸外科协会平均评分为6.4 ± 5.5%,86%患者的纽约心功能评级为III或IV级,平均左室射血分数为43 ± 12%。人工瓣膜成功在48例患者中植入,平均用时14min。术后30天死亡率为14%,无致残性卒中和反复介入治疗的发生。经过平均173天的随访,超声心动图结果显示在所有接受TMVR的患者中,二尖瓣反流均为轻度或者无残留,心功能评级也有明显改善(79%患者的纽约心功能评级为I或II级,p < 0.0001)。研究结果显示,经导管二尖瓣置换术在严重的二尖瓣反流患者中是可行的。原始出处:Vinayak B et al.Early Experience With New Transcatheter Mitral Valve Replacement. JACC,2018 Jan.本文系梅斯医学(MedSci)原创编译

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    2018-06-20 yxch48
  3. 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topicName=置换)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3a7c35056336, createdName=yxch48, createdTime=Wed Jun 20 13:35:00 CST 2018, time=2018-06-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1952628, encodeId=0bf7195262846, content=<a href='/topic/show?id=7366e827955' target=_blank style='color:#2F92EE;'>#经导管二尖瓣置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=171, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78279, encryptionId=7366e827955, topicName=经导管二尖瓣置换术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7ca4300, createdName=wodejia-dayu, createdTime=Fri Dec 07 11:35:00 CST 2018, time=2018-12-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1853893, encodeId=dfa91853893b9, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, 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objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/TDiaAWyicHgedzX3wKo3qcxudVJib7AfibfvNeufHRF2jG3Bw8MmZyWjIhtBV1mpJI7Sy9n7RcBKK5t3CuOKuOFxkg/0, createdBy=dd702206933, createdName=wzb521zf, createdTime=Fri Jan 12 06:59:52 CST 2018, time=2018-01-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=277441, encodeId=ee3a2e7441b6, content=一起学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=131, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/TDiaAWyicHgedzX3wKo3qcxudVJib7AfibfvNeufHRF2jG3Bw8MmZyWjIhtBV1mpJI7Sy9n7RcBKK5t3CuOKuOFxkg/0, createdBy=dd702206933, createdName=wzb521zf, createdTime=Thu Jan 11 07:36:04 CST 2018, time=2018-01-11, status=1, ipAttribution=), 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createdBy=fdb26536308, createdName=wwzzly, createdTime=Thu Jan 04 12:35:00 CST 2018, time=2018-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1510114, encodeId=d2251510114f2, 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 04 12:35:00 CST 2018, time=2018-01-04, status=1, ipAttribution=)]
    2018-10-13 hbwxf
  5. 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  6. 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createdBy=fdb26536308, createdName=wwzzly, createdTime=Thu Jan 04 12:35:00 CST 2018, time=2018-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1510114, encodeId=d2251510114f2, 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 04 12:35:00 CST 2018, time=2018-01-04, status=1, ipAttribution=)]
    2018-01-12 wzb521zf

    一起学习学习

    0

  7. 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createdBy=fdb26536308, createdName=wwzzly, createdTime=Thu Jan 04 12:35:00 CST 2018, time=2018-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1510114, encodeId=d2251510114f2, 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 04 12:35:00 CST 2018, time=2018-01-04, status=1, ipAttribution=)]
    2018-01-11 wzb521zf

    一起学习学习学习

    0

  8. 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  9. 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objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/TDiaAWyicHgedzX3wKo3qcxudVJib7AfibfvNeufHRF2jG3Bw8MmZyWjIhtBV1mpJI7Sy9n7RcBKK5t3CuOKuOFxkg/0, createdBy=dd702206933, createdName=wzb521zf, createdTime=Fri Jan 12 06:59:52 CST 2018, time=2018-01-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=277441, encodeId=ee3a2e7441b6, content=一起学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=131, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/TDiaAWyicHgedzX3wKo3qcxudVJib7AfibfvNeufHRF2jG3Bw8MmZyWjIhtBV1mpJI7Sy9n7RcBKK5t3CuOKuOFxkg/0, createdBy=dd702206933, createdName=wzb521zf, createdTime=Thu Jan 11 07:36:04 CST 2018, time=2018-01-11, status=1, ipAttribution=), 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createdBy=fdb26536308, createdName=wwzzly, createdTime=Thu Jan 04 12:35:00 CST 2018, time=2018-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1510114, encodeId=d2251510114f2, 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 04 12:35:00 CST 2018, time=2018-01-04, status=1, ipAttribution=)]
    2018-01-04 wwzzly
  10. 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    2018-01-04 lsj631

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虽然氢氯噻嗪(HCTZ)是一线抗高血压药物,但是在接受HCTZ治疗的高血压患者中仅有不到一半达到了理想的血压水平,因此,寻找能预测对HCTZ起反应的生物标志物迫在眉睫。本研究的目的旨在通过代谢组学、基因组学和脂类组学的方法寻找与HCTZ血压反应相关的新的生物标志物。首先,本研究对最近研究发现与HCTZ血压反应性相关的13中代谢产物进行了pathway分析,分析结果显示鞘脂类代谢途径是与HCTZ血压

JAHA:体重指数BMI与老年人血管疾病的发生风险相关

许多国家的平均寿命和体重指数(BMI)呈日益增长趋势,目前BMI与老年人的血管疾病之间的关系尚未阐明。本研究在1996年-1999年招募了12203名年龄≥65岁的普通人群,为了限制反向因果关系,本研究排除了有血管疾病史和随访前4年出现有血管疾病的对象。经过8年时间的随访,共出现有1136个主要血管疾病事件(非致死性心梗、非致死性卒中或血管源性死亡)。在65岁至94岁年龄段中,主要血管疾病发生风险

CIRC RES:国内学者揭示线粒体自噬介导心衰发生的分子机制

线粒体功能紊乱在心衰的发生中起到重要作用,然而,线粒体自噬介导的线粒体功能失调在心衰发生中的分子机制尚未阐明。本研究的目的旨在探究AMP激活的蛋白激酶(AMPK)在线粒体自噬介导的心衰中的作用。本研究在心衰病人的心肌样本和主动脉结扎(TAC)诱导型小鼠模型中检测到AMPK的异构体AMPKα2转变为AMPKα1,并伴随着线粒体自噬的减少和线粒体功能的失调。在TAC诱导的小鼠模型心脏中过表达AMPKα

美国心律学会和美国麻醉医师学会关于心血管植入型电子器械患者围术期处理专家共识解读

随着心血管植入型电子器械(CIED)的广泛应用,外科手术或其他医疗操作中遇到已经植入CIED 的患者越来越多,该类患者的围术期处理变得越来越重要。然而,CIED 的围术期管理是外科医师、麻醉医师甚至普通心血管内科医师的知识盲区,往往导致处理不到位或过于积极。因此,美国心律学会和美国麻醉科医师学会联合颁布了《植入型心律转复除颤器(ICD)、起搏器和心律失常检测器患者的围术期处理专家共识》。由于该领域

JACC:无症状的心梗发生心衰的风险就低了吗?

尽管寂静型心肌梗死(SMI)占了心梗患者的近一半,但是目前对于SMI患者发生心衰的风险如何尚属未知。本研究的目的旨在比较评估SMI患者与有临床症状的心梗(CMI)患者发生心衰的相关性。本研究纳入了ARIC临床研究中的9243名无基础心血管疾病的研究对象,寂静型心梗定义为超声心动图提示有心梗但是无临床症状。在ARIC随访1期和4期期间,共有305名SMI患者和331CMI患者,ARIC4期临床研究之

JAHA:β受体阻滞剂不会增加轻、中度AS患者的心血管风险

主动脉狭窄(AS)病人常常伴有高血压,由于担心对左室功能的抑制,所以这类病人的抗高血压治疗是禁止用β受体阻滞剂(Bbl)的。然而,对于无症状的轻到中度AS患者,Bbl对患者心血管的影响尚属未知。本研究纳入了SEAS研究中的1873名无症状的轻到中度AS伴保留型左室射血分数的患者,对其全因死亡率、心源性猝死和心源性死亡进行了分析。最终共有932名(50%)患者接受了Bbl治疗,经过平均4.3±0.9

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