术前FMR及术后MR与非缺血性心肌病CRT患者长期预后的关系  

Relationship between Preoperative FMR,Postoperative MR and Long-term Prognosis of CRT Patients with Non-ischemic Cardiomyopathy

作　　者：吕晓媛 赵勇[1] LV Xiaoyuan;ZHAO Yong(Department of Cardiology,the First Affiliated Hospital of Nanyang Medical College,Nanyang City,He’nan Province 473000)

机构地区：[1]南阳医学高等专科学校第一附属医院心内科,河南省南阳市473000

出　　处：《医学理论与实践》2022年第7期1081-1083,1090,共4页The Journal of Medical Theory and Practice

摘　　要：目的:探讨术前功能性二尖瓣反流(FMR)及术后二尖瓣反流(MR)与非缺血性心肌病心脏再同步化治疗(CRT)患者长期预后的关系。方法:回顾性分析我院2019年6月—2020年6月首次接受CRT的非缺血性心肌病患者96例,随访9个月。根据患者死亡发生情况将患者分为生存组(n=72)和死亡组(n=24)。收集两组患者一般资料、术前FMR严重程度、术后MR是否改善及超声心动图检查资料等,采用多因素COX回归分析影响患者死亡的独立因素,建立ROC曲线分析术前FMR严重程度、术后MR改善对患者长期预后的诊断价值。结果:死亡组左心室射血分数(LVEF)及术后MR改善病例数低于生存组,肺动脉收缩压(SPAP)及术前中重度MR病例数高于生存组(P<0.05);SPAP、术前中重度MR和MR改善是影响患者预后的独立影响因素(P<0.05);术前中重度MR诊断预后不良AUC=0.479,MR改善诊断预后不良AUC=0.667。结论:术前FMR严重程度和术后MR是否改善是影响非缺血性心肌病CRT患者预后的独立影响因素,术后MR改善对预后具有一定的诊断价值。Objective:To investigate the preoperative functional mitral regurgitation(FMR),postoperative mitral regurgitation(MR)and long-term prognosis of patients with non-ischemic cardiomyopathy cardiac resynchronization therapy(CRT).Methods:A retrospective analysis was performed in 96 patients with non-ischemic cardiomyopathy who received CRT for the first time in our hospital from June 2019 to June 2020,and were followed up for 9 months and divided into survival group(n=72) and death group(n=24) according to their deaths.The general data,the severity of preoperative FMR,postoperative MR improvement,and echocardiographic data were collected.Multivariate COX regression analysis was used to analyze the independent factors for patients death,and ROC curve analysis was established to analyze the diagnostic value of preoperative FMR severity and postoperative MR improvement for the long-term prognosis of patients.Results:The number of left ventricular ejection fraction(LVEF) and postoperative MR improvement in the death group was lower than that in the survival group,and the number of pulmonary artery systolic pressure(SPAP) and preoperative moderate to severe MR cases was higher than that in the survival group(P<0.05).SPAP and Preoperative moderate to severe MR and MR improvement were independent factors for the prognosis of patients(P<0.05).Preoperative moderate to severe MR diagnosis for poor prognosis was AUC=0.479,and MR improvement for poor prognosis was AUC=0.667.Conclusion:The severity of preoperative FMR and the improvement of postoperative MR are independent factors for the prognosis of CRT patients with non-ischemic cardiomyopathy.The improvement of postoperative MR has a certain diagnostic value for the prognosis.

关 键 词：功能性二尖瓣反流 二尖瓣反流 心脏再同步化治疗 心衰 

分 类 号：R541.51[医药卫生—心血管疾病]