经导管主动脉瓣置换术对主动脉瓣反流患者心功能及心室重构的影响:一项真实世界观察研究OA

Objective To evaluate the effect of transcatheter aortic valve replacement(TAVR)on cardiac function and ventricular remodeling in patients with pure aortic regurgitation(AR).Methods This study utilized data from the real-world,prospective,multicenter,observational clinical trial"TRUST TAVR REGISTRY"(NCT06381271).Patients with pure AR who underwent TAVR at Xijing Hospital of Air Force Medical University between October 2018 and July 2023 were included.Echocardiographic results were collected before TAVR,within 7 days after TAVR,and 1 year after TAVR to observe changes in cardiac function and cardiac structure in patients with pure AR after TAVR treatment.Results A total of 62 patients with pure AR who underwent TAVR were enrolled,including 35 males and 27 females,with an average age of(67.7±7.2)years.Echocardiographic results showed that compared with pre-TAVR,left ventricular ejection fraction(LVEF)had a downward trend within 7 days after TAVR(45.81%±10.40%vs.48.10%±9.86%,P=0.066),but the difference was not statistically significant.However,LVEF was significantly increased 1 year after TAVR(52.60%±7.93%vs.48.10%±9.86%,P=0.001).Compared with pre-TAVR,there was a significant reduction in left ventricular dimensions and volumes at 1 year after TAVR,including left ventricular end-systolic diameter[(37.82±8.87)mm vs.(46.35±9.50)mm,P<0.001],left ventricular end-diastolic diameter[(51.56±8.30)mm vs.(60.66±8.36)mm,P<0.001],left ventricular end-systolic volume[(55.46±39.25)ml vs.(91.72±44.06)ml,P<0.001],and left ventricular end-diastolic volume[(112.53±50.87)ml vs.(172.64±60.32)ml,P<0.001].Conclusion TAVR can improve cardiac function and reverse left ventricular remodeling in patients with pure AR at 1 year after surgery.