Preoperative Predictors of Death and Sustained Ventricular Tachycardia After Pulmonary Valve Replacement in Patients With Repaired Tetralogy of Fallot Enrolled in the INDICATOR Cohort
Preoperative Predictors of Death and Sustained Ventricular Tachycardia After Pulmonary Valve Replacement in Patients With Repaired Tetralogy of Fallot Enrolled in the INDICATOR Cohort
复制标题
DOI：
10.1161/circulationaha.118.034740
复制
发表时间：
2018-11-06
期刊：
影响因子：
37.8
通讯作者：
Valente, Anne Marie
中科院分区：
文献类型：
--
作者：
Geva, Tal;Mulder, Barbara;Valente, Anne Marie
背景资料：在肺动脉瓣置换术（PVR）前，已确定法洛四联症修复患者不良临床结局的风险因素。然而，前PVR预测PVR后持续性室性心动过速和死亡尚未identified.Methods：患者修复法洛四联症入组的指标队列（国际多中心TOF登记），4中心的国际队列研究，谁有一个全面的术前评估，随后接受PVR。分析术前临床、ECG、心血管磁共振和术后结局数据。考克斯比例风险多变量回归分析用于评估与从PVR前心血管磁共振到主要结局（死亡、流产的心源性猝死或持续性室性心动过速）的时间相关的因素。在452名合格患者中，（PVR时的中位年龄为25.8岁），36例（8%）达到主要结局（27例死亡，2例复苏死亡，7例持续性室性心动过速），PVR后中位时间为6.5年。考克斯比例风险回归确定PVR前右心室射血分数
Background: Risk factors for adverse clinical outcomes have been identified in patients with repaired tetralogy of Fallot before pulmonary valve replacement (PVR). However, pre-PVR predictors for post-PVR sustained ventricular tachycardia and death have not been identified.Methods: Patients with repaired tetralogy of Fallot enrolled in the INDICATOR cohort (International Multicenter TOF Registry), a 4-center international cohort study, who had a comprehensive preoperative evaluation and subsequently underwent PVR were included. Preprocedural clinical, ECG, cardiovascular magnetic resonance, and postoperative outcome data were analyzed. Cox proportional hazards multivariable regression analysis was used to evaluate factors associated with time from pre-PVR cardiovascular magnetic resonance until the primary outcome: death, aborted sudden cardiac death, or sustained ventricular tachycardia.Results: Of the 452 eligible patients (median age at PVR, 25.8 years), 36 (8%) reached the primary outcome (27 deaths, 2 resuscitated death, and 7 sustained ventricular tachycardia) at a median time after PVR of 6.5 years. Cox proportional hazards regression identified pre-PVR right ventricular ejection fraction