Predictors of Long-Term Outcome of Isolated Surgical Aortic Valve Replacement in Aortic Regurgitation With Reduced Left Ventricular Ejection Fraction and Extreme Left Ventricular Dilatation
Predictors of Long-Term Outcome of Isolated Surgical Aortic Valve Replacement in Aortic Regurgitation With Reduced Left Ventricular Ejection Fraction and Extreme Left Ventricular Dilatation
复制标题
孤立性主动脉瓣置换术治疗左心室射血分数降低和左心室极度扩张的主动脉瓣反流的长期结果的预测因素
DOI：
10.1016/j.amjcard.2020.01.041
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发表时间：
2020-05-01
影响因子：
2.8
通讯作者：
Wang, Yin
中科院分区：
文献类型：
--
作者：
Dong, Nianguo;Jiang, Weiwei;Wang, Yin
严重的主动脉瓣返流(AR)患者的左心功能减退和左心室极度扩张是一个两难的治疗难题。本研究旨在评估这些特殊人群的主动脉瓣置换术(AVR)的危险因素。对自2007年1月至2016年12月行单纯性房室成形术的212例伴左室射血分数(LVEF)为70 mm的重症AR患者进行回顾性分析。Logistic回归和受试者操作特征用于分析住院死亡率的预后指标，Kaplan-Meier分析用于长期生存。平均年龄56±13岁，平均LVEF 40+/-7%，平均LVEDD 78+/-6 mm。住院死亡率7%，5年和10年生存率分别为88+/-4%和73+/-10%。Logistic回归分析显示，住院死亡率与术前年龄和左心室射血分数有关。受试者工作特性分析显示，LVEF=35%是预测住院期间死亡的最佳临界值。Kaplan-Meier分析显示患者左心功能(LVEF)显著降低
The management of severe aortic regurgitation (AR) in patients with reduced left ventricular function and extreme left ventricular dilatation presents a therapeutic dilemma. This study aims to assess risk factors of aortic valve replacement (AVR) for these particular population based on its performances. Two hundred twelve severe AR patients accompanied by left ventricular ejection fraction (LVEF) = 70 mm who underwent isolated AVR between January 2007 and December 2016 were identified retrospectively. Logistic regression and receiver operating characteristic were used to analyze prognostic indicators for in-hospital mortality while Kaplan-Meier analysis for long-term survival. Mean age was 56 +/- 13 years with mean LVEF 40 +/- 7% and LVEDD 78 +/- 6 mm. In-hospital mortality rate was 7%, and survival rates at 5 and 10 years were 88 +/- 4% and 73 +/- 10%, respectively. Logistic regression analysis indicated in-hospital mortality was associated with preoperative age and LVEF. Receiver operating characteristic analysis showed LVEF = 35% was the best cut-off value at which to predict in-hospital death. Kaplan-Meier analysis revealed patients with markedly reduced LV function (LVEF