Clinical factors useful in predicting aortic valve structure in patients > 40 years of age with isolated valvular aortic stenosis.
Clinical factors useful in predicting aortic valve structure in patients > 40 years of age with isolated valvular aortic stenosis.
复制标题
可用于预测 40 岁以上孤立性主动脉瓣狭窄患者主动脉瓣结构的临床因素。
DOI：
10.1016/0002-9149(93)90159-a
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发表时间：
1993
影响因子：
2.8
通讯作者：
W. C. Roberts
中科院分区：
文献类型：
--
作者：
Gisela C. Mautner;S. L. Mautner;R. Cannon;S. Hunsberger;W. C. Roberts
许多报告描述了瓣膜性主动脉狭窄患者冠状动脉狭窄的频率。没有发表的报告检查成人主动脉瓣狭窄的结构，并将瓣膜结构与包括冠状动脉狭窄在内的变量联系起来，用于预测该结构。对188例孤立性瓣膜性主动脉瓣狭窄行主动脉瓣置换术的患者进行了研究。所有患者在主动脉瓣置换术时年龄均在40岁至40岁之间，术前均有冠状动脉造影，182例（97%）患者测量了血清总胆固醇，184例（98%）患者计算了体重指数。手术切除的主动脉瓣结构分为单尖瓣、二尖瓣（先天性畸形）或三尖瓣。建立logistic回归模型，发现4个因素（年龄、血清总胆固醇、血管造影冠状动脉疾病和体重指数）可预测主动脉瓣结构：(1)4个因素至少有3个或全部高或存在（即年龄bbb65岁、血清总胆固醇>200 mg/dl、体重指数>29 kg/m2和冠状动脉疾病）的患者先天性瓣膜畸形的概率较低（10 ~ 29%）；(2)至少3项或全部4项因素低或不存在（即年龄<65岁，血清总胆固醇≤200mg /dl，体重指数≤29kg /m2，无冠状动脉疾病）的患者发生先天性瓣膜畸形的概率高（72 ~ 90%）。因此，可以通过患者的年龄、血清总胆固醇、体重指数和冠状动脉状态来预测手术切除狭窄主动脉瓣的形态。
A number of reports have described the frequency of coronary arterial narrowing in patients with valvular aortic stenosis. No published reports have examined the structure of the stenotic aortic valve in adults and related the valve structure to variables, including coronary arterial narrowing, useful in predicting that structure. One hundred eighty-eight patients having aortic valve replacement for isolated valvular aortic stenosis were studied. All patients were >40 years of age at the time of aortic valve replacement, all had coronary angiograms preoperatively, and of 182 patients (97%) measurements of serum total cholesterol had been obtained and 184 (98%) had body mass index calculated. The structure of the operatively excised valve was classified as unicuspid or bicuspid (congenitally malformed), or tricuspid aortic valve. A logistic regression model was developed that found 4 factors (age, serum total cholesterol, angiographic coronary artery disease and body mass index) to be predictive of aortic valve structure: (1) Patients with at least 3 or all 4 factors high or present (i.e., age >65 years, serum total cholesterol >200 mg/dl, body mass index >29 kg/m2and coronary artery disease) had a low probability (10 to 29%) of having a congenitally malformed valve; (2) patients with at least 3 or all 4 factors low or absent (i.e., age <65 years, serum total cholesterol ≤200 mg/dl, body mass index ≤29 kg/m2, and no coronary artery disease) had a high probability (72 to 90%) of having a congenitally malformed valve. Thus, the morphology of the operatively excised stenotic aortic valve can be predicted with knowledge of the age, serum total cholesterol, body mass index and coronary artery status of the patient.