Comparison of therapeutic effects of transcatheter aortic valve replacement surgery on patients with severe aortic valve stenosis with different ejection fractions
Journal Title: Chinese Journal of Clinical Research - Year 2024, Vol 37, Issue 6
Abstract
Objective To investigate the efficacy of transcatheter aortic valve replacement (TAVR) in treating patients with severe aortic stenosis (AS) of different levels of cardiac function. Methods A retrospective analysis was conducted on clinical data of 72 patients who underwent TAVR for severe AS at the Xinjiang Uygur Autonomous Region People's Hospital from September 2016 to July 2022. Patients with a left ventricular ejection fraction (LVEF) ≥50% were included in the preserved ejection fraction group (group A, n =44), while those with LVEF<50% were included in the reduced ejection fraction group (group B, n =28). The effective orifice area (EOA), mean transvalvular pressure gradient, and left ventricular remodeling (LVR) were observed in both groups preoperatively and postoperatively at 1 day, 3 months, and 12 months. The 6-minute walk distance (6-MWD) was measured preoperatively and postoperatively at 3 months and 12 months for both groups. All patients were followed up to one year postoperatively to observe the readmission rate due to heart failure. Results Both groups showed significant improvement in EOA and mean transvalvular pressure gradient on the first postoperative day, which remained stable thereafter. On the first postoperative day, LVR indicators [left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular posterior wall thickness (LVPWT), LVEF] improved significantly in both groups compared to preoperative values ( P <0.05). During subsequent follow-ups, group A maintained a relatively stable state, while group B continued to show LVR until the end of the follow-up period. The 6-MWD at 3 months postoperatively improved significantly in both groups compared to preoperative values and remained stable thereafter. The readmission rate due to heart failure within one year between group A and group B showed no statistically significant difference (4.54% vs 21.43%, χ 2 =3.380, P =0.066). Conclusion TAVR can effectively alleviate obstruction of the left ventricular outflow tract in patients with severe AS and different ejection fractions, improve exercise tolerance, and promote left ventricular reverse remodeling. For patients with preserved ejection fraction and severe AS, intervention should be carried out as early as possible.
Authors and Affiliations
KONG Can, GUO Zitong, Zulipiyem Xier, FAN Hao, PENG Hui
Improvement of lumbar spine function in patients with lumbar spinal stenosis by spinal endoscopic bilateral decompression of the spinal canal with unilateral interlaminar approach
<b>Objective</b> To analyze the effect of spinal endoscopic unilateral interlaminar approach with bilateral decompression of the spinal canal in the improvement of lumbar spine function in patients with lumbar spinal st...
Serum Presepsin and GDF-15 levels in patients with acute myocarditis and their correlation with inflammatory level and cardiac function
Objective To investigate the levels of serum soluble CD14 subtype (Presepsin) and growth differentiation factor 15 (GDF-15) in patients with acute myocarditis and their correlation with inflammation factor levels and car...
Dapagliflozin combined with sitagliptin in treatment of type 2 diabetes
Objective To investigate the efficacy of single drug treatment of dapagliflozin and combination of dapagliflozin and sitagliptin in the treatment of type 2 diabetes mellitus (T2DM). Methods Sixty-two patients with T2DM...
Comparison of analgesic effects between ultrasound-guided thoracic paravertebral block and intercostal nerve block in patients with multiple rib fractures
"<b>Objective</b> To compare the analgesic effects and safety of ultransound-guided thoracic paravertebral block (TPVB) and intercostal nerve block (INB) in patients with unilateral multiple rib fractures. <b>Methods<...
Research progress of short-chain fatty acids and the relationship between immune regulation and sepsis
Short-chain fatty acids are saturated fatty acids produced by specific intestinal flora, which have various functions such as maintaining intestinal homeostasis and participating in immune regulation. In recent years, th...