Observations on the optimum time for operative intervention for aortic regurgitation. II. Serial echocardiographic evaluation of asymptomatic patients.
Observations on the optimum time for operative intervention for aortic regurgitation. II. Serial echocardiographic evaluation of asymptomatic patients.
复制标题
主动脉瓣关闭不全手术干预最佳时机的观察。
DOI：
10.1161/01.cir.61.3.484
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发表时间：
1980
期刊：
影响因子：
37.8
通讯作者：
S. Epstein
中科院分区：
文献类型：
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作者：
W. Henry;R. Bonow;D. Rosing;S. Epstein
最近一项针对因孤立性主动脉瓣返流而接受主动脉瓣置换术的症状性患者的超声心动图研究表明，术前左心室收缩末期内径（LVD[mm]）超过55 mm或缩短分数（%FS）小于25%的患者发生充血性心力衰竭和在其他成功手术后死亡的风险较高。由于左心室收缩功能指标可能识别无症状的主动脉瓣关闭不全患者，这些患者可能从早期手术中受益，因此对37例此类患者进行了连续超声心动图评价（平均随访34个月）。14名患者（38%）随后出现症状，并建议进行手术（SUBSQ OP）。23例患者（62%）在随访期间保持无症状（NON OP）。LVD（LVD）和%FS是在初次检查时区分随后需要手术的患者与不需要手术的患者的最敏感测量值（LVD[LVD] 53.0 mm SUBSQ OP vs 44.3 mm NON OP，p = 0.001; %FS 28.8% SUBSQ OP vs 33.9% NON OP，p = 0.002）。在系列研究中，只有一名患者的收缩末期尺寸的最大变化率超过7 mm/年。收缩末期内径大于55 mm的5例患者中有4例（80%）出现症状，并在手术期间进行了手术。
A recent echocardiographic study of symptomatic patients who had aortic valve replacement for isolated aortic regurgitation indicated that patients in whom preoperative left ventricular end-systolic dimension (LVD[SYS]) exceeded 55 mm or fractional shortening (%FS) was less than 25% were at high risk of developing congestive heart failure and dying after an otherwise successful operation. Because indices of left ventricular systolic function might identify asymptomatic patients with aortic regurgitation who might benefit from earlier operation, 37 such patients were evaluated with serial echocardiograms (mean follow-up 34 months). Fourteen patients (38%) subsequently developed symptoms and were recommended for operation (SUBSQ OP). Twenty-three patients (62%) remain asymptomatic during follow-up (NON OP). LVD(SYS) and %FS were the most sensitive measurements for distinguishing on initial examination the patients who subsequently required operation from those who have not (LVD[SYS] 53.0 mm SUBSQ OP vs 44.3 mm NON OP, p = 0.001; %FS 28.8% SUBSQ OP vs 33.9% NON OP,p = 0.002). During serial studies, the maximum rate of change in end-systolic dimension exceeded 7 mm per year in only one patient. Four of five patients (80%) with end-systolic dimension greater than 55 mm developed symptoms and came to operation during a
DOI：
--
发表时间：
1972
期刊：
--
影响因子：
--
作者：
D. Cox
通讯作者：
D. Cox