Impact of perioperative change in physical function on midterm outcomes after transcatheter aortic valve implantation
Impact of perioperative change in physical function on midterm outcomes after transcatheter aortic valve implantation
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围手术期身体功能变化对经导管主动脉瓣植入术后中期结果的影响
DOI：
10.1007/s00380-021-01776-4
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发表时间：
2021
影响因子：
1.5
通讯作者：
Akashi Yoshihiro J.
中科院分区：
文献类型：
--
作者：
Ashikaga Kohei;Doi Shunichi;Yoneyama Kihei;Watanabe Mika;Suzuki Norio;Kuwata Shingo;Kaihara Toshiki;Koga Masashi;Okuyama Kazuaki;Kamijima Ryo;Tanabe Yasuhiro;Takeichi Naoya;Watanabe Satoshi;Izumo Masaki;Kida Keisuke;Akashi Yoshihiro J.
术前虚弱降低了经导管主动脉瓣植入术（TAVI）后功能恢复的可能性。然而，TAVI术后围手术期身体状况的变化及其对预后的影响尚未报道。因此，本研究旨在研究围手术期身体功能变化是否影响接受TAVI的患者的预后。我们回顾性分析了257例接受TAVI的患者。在TAVI术前和术后评价了短期身体功能成套测验（SPPB），这是一种客观的身体状态评估工具。患者分为两组：（i）SPPB评分在围手术期下降的患者（下降组）和（ii）SPPB评分在围手术期未下降的患者（非下降组）。主要终点是TAVI后因心力衰竭或心血管死亡而计划外住院。平均随访期为385 ± 151天，平均年龄为83.2 ± 5.8岁，67%的患者为女性。16名患者因心力衰竭需要再次入院，7名患者发生心血管相关死亡。Kaplan-Meier分析显示，下降组的无事件率显著较低（对数秩，p= 0.006）。逐步多变量logistic回归分析显示，围手术期SPPB的变化与主要终点显著相关（比值比，1.51; 95%置信区间，1.12-2.04）。围手术期身体功能变化是TAVI后心力衰竭、住院或心血管死亡的独立风险因素。
Preoperative frailty diminishes the potential for functional recovery after transcatheter aortic valve implantation (TAVI). However, perioperative changes in physical status and their impact on prognosis after TAVI have not previously been reported. Therefore, this study aimed to investigate whether perioperative changes in physical function affect prognosis in patients undergoing TAVI. We retrospectively reviewed 257 patients who underwent TAVI. The Short Physical Performance Battery (SPPB), an objective physical status assessment tool, was evaluated pre- and post-TAVI. Patients were divided into two groups: (i) patients whose SPPB score declined in the perioperative period (the decline group) and (ii) patients whose SPPB score did not decline in the perioperative period (the non-decline group). The primary endpoint was unplanned hospitalization owing to heart failure or cardiovascular death following TAVI. The mean follow-up period was 385 ± 151 days, mean age was 83.2 ± 5.8 years, and 67% of the patients were women. Sixteen patients required readmission owing to heart failure, and seven experienced cardiovascular-related death. Kaplan–Meier analysis revealed that the event-free rate was significantly lower in the decline group (log-rank,p= 0.006). A stepwise multivariate logistic regression analysis showed that a perioperative change in SPPB was significantly associated with primary endpoints (odds ratio, 1.51; 95% confidence interval, 1.12–2.04). Perioperative change in physical function was an independent risk factor for heart failure, hospitalization, or cardiovascular death following TAVI.
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[心脏和血管]。
DOI：
10.1007/380.1615-2573
发表时间：
1966
期刊：
Klinicheskaia meditsina
影响因子：
--
作者：
V. A. Val'dman
通讯作者：
V. A. Val'dman
影响因子：
11.3
作者：
Kiani, Soroosh;Stebbins, Amanda;Devireddy, Chandan
通讯作者：
Devireddy, Chandan
影响因子：
1.5
作者：
Ashikaga, Kohei;Saji, Mike;Isobe, Mitsuaki
通讯作者：
Isobe, Mitsuaki
Deharo 等人对有关文章“Sapien 3 球囊扩张型与 Evolut R 自扩张型经导管主动脉瓣植入对主动脉瓣狭窄患者的影响：来自全国范围分析的数据”的回复。
影响因子：
37.8
作者：
P. Deharo;A. Bisson;C. Saint Etienne;L. Fauchier
通讯作者：
L. Fauchier
影响因子：
5.7
作者：
Barbanti, Marco;Capranzano, Piera;Tamburino, Corrado
通讯作者：
Tamburino, Corrado