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首页> 外文期刊>Circulation: An Official Journal of the American Heart Association >Permanent pacemaker implantation after transcatheter aortic valve implantation impact on late clinical outcomes and left ventricular function
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Permanent pacemaker implantation after transcatheter aortic valve implantation impact on late clinical outcomes and left ventricular function

机译：经沟管主动脉瓣植入后的永久起搏器植入对晚期临床结果和左心室功能的影响

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摘要

Background: Very few data exist on the clinical impact of permanent pacemaker implantation (PPI) after transcatheter aortic valve implantation. The objective of this study was to assess the impact of PPI after transcatheter aortic valve implantation on late outcomes in a large cohort of patients. Methods and Results: A total of 1556 consecutive patients without prior PPI undergoing transcatheter aortic valve implantation were included. Of them, 239 patients (15.4%) required a PPI within the first 30 days after transcatheter aortic valve implantation. At a mean follow-up of 22±17 months, no association was observed between the need for 30-day PPI and all-cause mortality (hazard ratio, 0.98; 95% confidence interval, 0.74-1.30; P=0.871), cardiovascular mortality (hazard ratio, 0.81; 95% confidence interval, 0.56-1.17; P=0.270), and all-cause mortality or rehospitalization for heart failure (hazard ratio, 1.00; 95% confidence interval, 0.77-1.30; P=0.980). A lower rate of unexpected (sudden or unknown) death was observed in patients with PPI (hazard ratio, 0.31; 95% confidence interval, 0.11-0.85; P=0.023). Patients with new PPI showed a poorer evolution of left ventricular ejection fraction over time (P=0.017), and new PPI was an independent predictor of left ventricular ejection fraction decrease at the 6-to 12-month follow-up (estimated coefficient, -2.26; 95% confidence interval, -4.07 to -0.44; P=0.013; R 2=0.121). Conclusions: The need for PPI was a frequent complication of transcatheter aortic valve implantation, but it was not associated with any increase in overall or cardiovascular death or rehospitalization for heart failure after a mean follow-up of ≈2 years. Indeed, 30-day PPI was a protective factor for the occurrence of unexpected (sudden or unknown) death. However, new PPI did have a negative effect on left ventricular function over time.
机译：背景：在经螺旋桨主动脉瓣植入后永久性起搏器植入（PPI）的临床影响很少存在数据。本研究的目的是评估经膜管主动脉瓣膜植入经型患者的晚期结果后PPI对患者的影响。方法和结果：共有1556例连续1556名没有现有的PPI经过经沟管主动脉瓣注入。在它们中，239名患者（15.4％）在经截面主动脉瓣植入后30天内需要PPI。在平均随访22±17个月，不需要30天PPI和全因死亡率（危险比，0.98; 95％置信区间，0.74-1.30; p = 0.871），心血管死亡率（危险比，0.81; 95％置信区间，0.56-1.17; p = 0.270），以及心力衰竭的全因死亡率或再生生长（危险比，1.00; 95％置信区间，0.77-1.30; p = 0.980） 。在PPI患者（危险比0.31; 95％置信区间，0.11-0.85; p = 0.023）中，观察到较低的意外（突然或未知）死亡率较低。新PPI的患者显示出左心室喷射部分随时间较差的（P = 0.017），新的PPI是左心室喷射分数的独立预测因子在6至12个月的随访中减少（估计系数， - 2.26; 95％置信区间，-4.07至-0.44; p = 0.013; r 2 = 0.121）。结论：PPI的需求是经截觉管主动脉瓣植入的频繁并发症，但在≈2年的平均随访后，与心力衰竭的总体或心血管死亡或再生中的任何增加无关。实际上，30天的PPI是发生意外（突然或未知）死亡的保护因素。然而，新的PPI随着时间的推移对左心室功能产生负面影响。

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    UrenaM.; WebbJ.G.; TamburinoC.; Mu?oz-GarcíaA.J.; CheemaA.; DagerA.E.; SerraV.; Amat-SantosI.J.; BarbantiM.; ImmèS.; BrialesJ.H.A.; BenitezL.M.; AlLawatiH.; CucalonA.M.; DelBlancoB.G.; LópezJ.; DumontE.; DeLarochellièreR.; RibeiroH.B.; Nombela-FrancoL.; PhilipponF.; Rodés-CabauJ.;

  • 作者单位

    Quebec Heart and Lung Institute Laval University 2725 Chemin Ste-Foy G1V 4G5 Quebec City QC;

    St. Paul's Hospital University of British Columbia Vancouver BC Canada;

    Ferrarotto Hospital University of Catania Catania Italy;

    Hospital Clínico de Málaga Universidad de Málaga Málaga Spain;

    St. Michael's Hospital Toronto University Toronto ON Canada;

    Clínica de Occidente de Cali Cali Colombia;

    Hospital Universitari Vall d'Hebron Universitat Autonoma de Barcelona Barcelona Spain;

    Hospital Clinico Universitario de Valladolid Valladolid Spain;

    St. Paul's Hospital University of British Columbia Vancouver BC Canada Ferrarotto Hospital;

    Ferrarotto Hospital University of Catania Catania Italy;

    Hospital Clínico de Málaga Universidad de Málaga Málaga Spain;

    Clínica de Occidente de Cali Cali Colombia;

    St. Michael's Hospital Toronto University Toronto ON Canada;

    Clínica de Occidente de Cali Cali Colombia;

    Hospital Universitari Vall d'Hebron Universitat Autonoma de Barcelona Barcelona Spain;

    Hospital Clinico Universitario de Valladolid Valladolid Spain;

    Quebec Heart and Lung Institute Laval University 2725 Chemin Ste-Foy G1V 4G5 Quebec City QC;

    Quebec Heart and Lung Institute Laval University 2725 Chemin Ste-Foy G1V 4G5 Quebec City QC;

    Quebec Heart and Lung Institute Laval University 2725 Chemin Ste-Foy G1V 4G5 Quebec City QC;

    Quebec Heart and Lung Institute Laval University 2725 Chemin Ste-Foy G1V 4G5 Quebec City QC;

    Quebec Heart and Lung Institute Laval University 2725 Chemin Ste-Foy G1V 4G5 Quebec City QC;

    Quebec Heart and Lung Institute Laval University 2725 Chemin Ste-Foy G1V 4G5 Quebec City QC;

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  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 心脏、血管（循环系）疾病;
  • 关键词

    Aortic stenosis; Aortic valve; Artificial; Cardiac; Death; Heart valves; Pacemaker; Sudden;

    机译：主动脉狭窄;主动脉瓣;人造;心脏;死亡;心脏瓣膜;起搏器;突然;

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