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首页> 外文期刊>Circulation journal >Impact of Prosthesis-Patient Mismatch on Late Recurrence of Atrial Fibrillation After Cryomaze Procedure With Mitral Valve Replacement
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Impact of Prosthesis-Patient Mismatch on Late Recurrence of Atrial Fibrillation After Cryomaze Procedure With Mitral Valve Replacement

机译：人工晶体与患者不匹配对二尖瓣置换术冷冻治疗后房颤晚期复发的影响

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Background:This study investigated the impact of prosthesis-patient mismatch (PPM) after mitral valve replacement (MVR) with cryoablation using a maze procedure.Methods?and?Results:We evaluated 142 patients who underwent MVR with a cryomaze procedure. Echocardiography was performed at 1 week and at 1, 3, 5, 7, and 10 years. An effective orifice area index of 1.2 cm2/m2was used to define PPM. Mean transmitral pressure gradient (mean MPG) >5 mmHg was defined as high. PPM was a risk for overall mortality and a predictor of admission for heart failure. Mean MPG at 1 week was significantly higher in PPM patients (4.8±1.5 mmHg vs. 3.7±1.2 mmHg, P<0.001). Left atrium (LA) dimension decreased after the operation and did not change in patients without high mean MPG, while it increased after 7 years in patients with high mean MPG. The significant predictor of AF recurrence after 1 year was LA dimension ≥52.9 mm. Yearly AF recurrence was 10.6% in patients with LA dimension ≥52.9 mm, and 1.8% in the others. In patients with high mean MPG, tricuspid regurgitation pressure gradient (TRPG), related to pulmonary artery pressure, was increased after 7 years.Conclusions:PPM is a risk for late mortality, admission for heart failure, and high mean MPG, while the last was related to risk of enlargement of LA and increase of TRPG after 7 years. LA dimension after surgery is a predictor of late recurrence of AF, especially when ≥52.9 mm. (Circ J 2014; 78: 1908–1914)
机译：背景：本研究使用迷宫手术方法研究了二尖瓣置换术（MVR）和冷冻消融术对假体-患者不匹配（PPM）的影响。方法和结果：我们评估了142例接受冷冻治疗的MVR患者。在1周，1、3、5、7和10年时进行超声心动图检查。有效孔口面积指数为1.2 cm 2 / m 2 来定义PPM。大于5 mmHg的平均透射压力梯度（平均MPG）定义为高。 PPM是整体死亡率的风险，也是心力衰竭入院的预测指标。 PPM患者在1周时的平均MPG显着更高（4.8±1.5 mmHg与3.7±1.2 mmHg，P <0.001）。没有平均MPG高的患者术后左心房（LA）尺寸减小，并且没有变化，而平均MPG高的患者在7年后左心房尺寸增加。 1年后房颤复发的重要预测指标是LA尺寸≥52.9mm。 LA尺寸≥52.9mm的患者每年AF复发率为10.6％，其他患者为1.8％。在平均MPG高的患者中，与肺动脉压相关的三尖瓣关闭不全压力梯度（TRPG）在7年后升高。结论：PPM有晚期死亡，心力衰竭和高平均MPG的风险，而最后一次与7年后LA增大和TRPG升高的风险有关。手术后的LA尺寸是AF复发的预测指标，尤其是≥52.9mm时。 （Circ J 2014; 78：1908-1914）

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