二叶式主动脉瓣与三叶式主动脉瓣对TAVR术后患者左心室逆向重构的影响

EFFECTS OF BICUSPID VERSUS TRICUSPID AORTIC VALVE ON LEFT VENTRICULAR REVERSE REMODELING IN PATIENTS AFTER TRANSCATHETER AORTIC VALVE REPLACEMENT

目的比较二叶式主动脉瓣(BAV)和三叶式主动脉瓣(TAV)对经导管主动脉瓣置换术(TAVR)后患者左心室逆向重构的影响。方法回顾性分析我院TAVR术后至少有3次连续超声心动图随访(1、3个月和1年)的67例患者的临床资料,比较BAV和TAV对经TAVR治疗后患者左心室逆向重构的影响。结果67例患者中BAV 23例,TAV 44例。两组患者术前基线资料比较差异无显著性(P>0.05);两组患者术后肺动脉收缩压(PASP)、左心室质量分数(LVMi)、相对室壁厚度(RWT)均随时间延长逐渐下降(F=3.64~25.59,P<0.05);术后1年BAV组的LVMi明显小于TAV组(F=16.98,P<0.05)。两组术后病死率及并发症发生率差异均无显著性(P>0.05)。结论BAV与TAV患者在接受TAVR术后均发生明显的左心室逆向重构,两者治疗效果相近。

Objective To compare the effects of a bicuspid aortic valve(BAV)and a tricuspid aortic valve(TAV)on the reverse remodeling of left ventricle after transcatheter aortic valve replacement(TAVR).Methods We retrospectively analyzed the clinical data of 67 patients who had undergone TAVR and had at least three consecutive echocardiographic follow-ups(at 1 month,3 months,and 1 year,respectively)in our hospital,and compared the effects of BAV and TAV on the reverse remodeling of left ventricle after TAVR.Results Among the 67 patients,there were 23 cases of BAV and 44 cases of TAV.No significant differences were observed in preoperative baseline data between the two groups(P>0.05).Pulmonary artery systolic pressure,left ventricular mass index(LVMI),and relative wall thickness were significantly decreased with time after operation for both groups(F=3.64-25.59,P<0.05).LVMI at 1 year after operation was significantly lower in the BAV group than in the TAV group(F=16.98,P<0.05).There were no significant differences in mortality and complication incidence after operation between the two groups(P>0.05).Conclusion Both patients with BAV and TAV show significant left ventricular reverse remodeling after TAVR and have similar treatment outcomes.