主动脉瓣狭窄的心脏损伤分期在临床中的应用及研究进展

Clinical application and research progress of heart injury staging in aortic stenosis

主动脉瓣狭窄会导致不同程度的心脏结构损伤,大量临床研究证实,严重的心脏结构损伤与重度主动脉瓣狭窄患者的不良预后相关。为进一步了解心脏结构损伤与主动脉瓣狭窄的关系,2017年首次提出了基于超声心动图的心脏损伤分期,用以评估心脏结构损伤的程度及其对主动脉瓣狭窄患者预后的影响,随后被诸多研究不断证实与修订。这一分期系统有助于对主动脉瓣狭窄患者进行风险分层,合理选择手术干预时机,优化治疗策略,进而改善主动脉瓣狭窄患者的预后。本文将从病理生理机制、临床应用场景、长期预后预测价值以及未来发展方向进行阐述。

Aortic stenosis can lead to different degrees of cardiac structural damage.A large number of clinical studies have confirmed that severe cardiac structural damage is associated with poor prognosis in patients with severe aortic stenosis.In order to further understand the relationship between cardiac structural damage and aortic stenosis,echocardiography-based cardiac injury staging was first proposed in 2017 to evaluate the degree of cardiac structural damage and its impact on the prognosis of patients with aortic stenosis,which was subsequently confirmed and revised by many studies.This staging system helps to stratify the risk of patients with aortic stenosis,reasonably select the timing of surgical intervention,optimize treatment strategies,and improve the prognosis of patients with aortic stenosis.This article will elaborate on the pathophysiological mechanism,clinical application scenarios,long-term prognostic value and future development direction.