Risk of arterial embolization in 224 patients awaiting cardiac transplantation.
Risk of arterial embolization in 224 patients awaiting cardiac transplantation.
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224 名等待心脏移植患者的动脉栓塞风险。
DOI：
10.1016/0002-8703(95)90286-4
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发表时间：
1995
影响因子：
4.8
通讯作者：
Stevenson,LW
中科院分区：
文献类型：
--
作者：
Natterson,PD;Stevenson,WG;Saxon,LA;Middlekauff,HR;Stevenson,LW
在等待心脏移植的患者中，10% 至 20% 在供体心脏可用之前死亡。左心室血栓栓塞是该人群发病和死亡的一个根源。为了确定全身动脉栓塞的发生率和可能的危险因素，我们检查了 224 名连续等待心脏移植的门诊患者（左心室射血分数 0.20 ± 0.07，左心室舒张末期内径 76 ± 11 mm）的动脉栓塞事件的频率及其与临床、血流动力学和超声心动图变量的关系。在 301 ± 371 天的随访期内，82 名（37%）患者接受华法林治疗，6 名（3%）患者发生动脉栓塞，其中 1 名患者正在接受华法林治疗，5 名患者未接受华法林治疗（差异无统计学意义）。无论是否接受华法林治疗，房颤、既往栓塞或经胸超声心动图显示左心室血栓的患者的栓塞风险没有统计学差异。对于有或没有超声心动图记录的左心室血栓的患者，猝死的累积风险相似。 2 名 (2%) 患者出现与华法林治疗相关的非致命性出血并发症。因此，在等待心脏移植以及因左心室血栓、心房颤动或既往动脉栓塞而接受抗凝治疗的患者中，尽管心室严重扩张，但临床上可检测到的动脉栓塞的发生率较低。栓塞不太可能是该人群猝死或发病的主要原因。
Of patients awaiting cardiac transplantation, 10% to 20% die before a donor heart becomes available. Embolization of left ventricular thrombus is a source of morbidity and mortality in this population. To define the incidence and possible risk factors for systemic arterial embolization, we examined the frequency of arterial embolic events and their relatiion to clinical, hemodynamic, and echocardiographic variables in 224 consecutive outpatients awaiting cardiac transplantation (left ventricular ejection fraction 0.20 ± 0.07 and left ventricular end-diastolic dimension 76 ± 11 mm). Over a follow-up period of 301 ± 371 days, during which 82 (37%) patients received warfarin, arterial embolization occurred in 6 (3%) patients, 1 of whom was receiving and 5 of whom were not receiving warfarin (difference not statistically significant). The risk of embolization was not statistically different in patients with atrial fibrillation, previous embolization, or left ventriulcar thrombus on transthoracic echocardiogram, regardless of warfarin therapy. Cumulative risk of sudden death was similar for patients with or without achocardiographically documented left ventricular thrombus. Nonfatal bleeding complications associated with warfarin therapy occurred in 2 (2%) patients. Thus in patients who are awaiting cardiac transplantation and who receive anticoagulation therapy for left ventricular thrombus, atrial fibrillation, or previous arterial embolization, the incidence of clinically detectable arterial embolization is low despite severe ventricular dilatation. Embolization is not likely a major cause of sudden death or morbidity in this population.
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DOI：
10.1056/nejm199011293232201
发表时间：
1990-11
期刊：
The New England journal of medicine
影响因子：
--
作者：
D. Singer;R. Hughes;D. Gress;Mary A. Sheehan;L. Oertel;S. W. Maraventano;D. Blewett;B. Rosner;J. Kistler
通讯作者：
D. Singer;R. Hughes;D. Gress;Mary A. Sheehan;L. Oertel;S. W. Maraventano;D. Blewett;B. Rosner;J. Kistler
呼吁对扩张型心肌病进行抗凝临床试验。
DOI：
10.1016/0002-9149(90)91436-a
发表时间：
1990
期刊：
The American journal of cardiology
影响因子：
--
作者：
Rodney H. Falk
通讯作者：
Rodney H. Falk
影响因子：
4.8
作者：
FALK, RH;FOSTER, E;COATS, MH
通讯作者：
COATS, MH
影响因子：
37.8
作者：
HAUGLAND, JM;ASINGER, RW;HODGES, M
通讯作者：
HODGES, M
影响因子：
4.8
作者：
BLONDHEIM, DS;JACOBS, LE;PARRY, WR
通讯作者：
PARRY, WR