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HEART:经导管主动脉瓣植入后肾素-血管紧张素抑制剂的作用巨大!

2017-10-14 MedSci MedSci原创

左心室肥厚的持续存在与主动脉瓣狭窄经导管主动脉瓣植入术(TAVI)后的临床结果差相关。然而,TAVI之后的最佳疗法目前仍然未知。近期,一项发表在杂志HEART上的研究调查了肾素-血管紧张素系统(RAS)阻断治疗对接受TAVI后患者的LV肥大和死亡率的影响。此项研究招募了自2013年10月至2016年4月期间,1215例参加了优化的CathEter vAvular Iterter(OCEAN)-TA

左心室肥厚的持续存在与主动脉瓣狭窄经导管主动脉瓣植入术(TAVI)后的临床结果差相关。然而,TAVI之后的最佳疗法目前仍然未知。


近期,一项发表在杂志HEART上的研究调查了肾素-血管紧张素系统(RAS)阻断治疗对接受TAVI后患者的LV肥大和死亡率的影响。

此项研究招募了自2013年10月至2016年4月期间,1215例参加了优化的CathEter vAvular Iterter(OCEAN)-TAVI登记的TAVI治疗患者。根据RAS阻断治疗与血管紧张素转换酶(ACE)抑制剂或血管紧张素受体阻滞剂(ARB)的术后使用情况,将该人群队列分层。在TAVI后180天至少两次处方以及至少6个月的随访组成的RAS阻断组(n = 371),而在TAVI后没有任何ACE抑制剂或ARB治疗的患者被纳入无RAS阻断组(n = 189)。

此项研究结果显示:术后6个月,RAS阻断组的LV质量指数回归显着高于无RAS阻滞组(-9±24%vs -2±25%,p = 0.024)。Kaplan-Meier分析显示RAS阻断的累积2年死亡率明显低于无RAS阻断组(7.5%vs 12.5%;log-rank检验,p = 0.031)。调整混杂因素后,RAS阻断治疗与全因死亡率明显降低相关(HR,0.45;95%CI为0.22〜0.91;p = 0.025)。

此项研究结果表明:术后RAS阻断治疗与左心室质量指数回归增加以及全因死亡率降低有关。

原始出处:
Ochiai T, Saito S, et al. Renin-angiotensin system blockade therapy after transcatheter aortic valve implantation. Heart. 2017 Oct 6. pii: heartjnl-2017-311738. doi: 10.1136/heartjnl-2017-311738. 

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    2018-07-12 jklm09
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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1589305, encodeId=969a1589305af, content=<a href='/topic/show?id=fb0389e4373' target=_blank style='color:#2F92EE;'>#血管紧张素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89743, encryptionId=fb0389e4373, topicName=血管紧张素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5ce517702394, createdName=xiongliangxl, createdTime=Mon Oct 16 07:33:00 CST 2017, time=2017-10-16, status=1, ipAttribution=)]
    2017-10-16 131****1460

    学习了受益匪浅

    0

  4. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1589305, encodeId=969a1589305af, content=<a href='/topic/show?id=fb0389e4373' target=_blank style='color:#2F92EE;'>#血管紧张素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89743, encryptionId=fb0389e4373, topicName=血管紧张素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5ce517702394, createdName=xiongliangxl, createdTime=Mon Oct 16 07:33:00 CST 2017, time=2017-10-16, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1851544, encodeId=4d361851544b5, content=<a href='/topic/show?id=f0a254918f0' target=_blank style='color:#2F92EE;'>#抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Thu Jul 12 03:33:00 CST 2018, time=2018-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1935928, encodeId=dced193592861, content=<a href='/topic/show?id=6d06e826033' target=_blank style='color:#2F92EE;'>#经导管主动脉瓣植入#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78260, encryptionId=6d06e826033, topicName=经导管主动脉瓣植入)], attachment=null, authenticateStatus=null, createdAvatar=, 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encryptionId=1dd6231822d, topicName=主动脉瓣)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc4b2500077, createdName=hittouch, createdTime=Mon Oct 16 07:33:00 CST 2017, time=2017-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356530, encodeId=b575135653035, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Mon Oct 16 07:33:00 CST 2017, time=2017-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415204, encodeId=b7e614152046f, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, 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href='/topic/show?id=7a736264553' target=_blank style='color:#2F92EE;'>#植入#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62645, encryptionId=7a736264553, topicName=植入)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=21015, createdName=heli0118, createdTime=Mon Oct 16 07:33:00 CST 2017, time=2017-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562713, encodeId=3fa31562e1353, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Mon Oct 16 07:33:00 CST 2017, time=2017-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1589305, encodeId=969a1589305af, content=<a href='/topic/show?id=fb0389e4373' target=_blank style='color:#2F92EE;'>#血管紧张素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89743, encryptionId=fb0389e4373, topicName=血管紧张素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5ce517702394, createdName=xiongliangxl, createdTime=Mon Oct 16 07:33:00 CST 2017, time=2017-10-16, status=1, ipAttribution=)]
    2017-10-16 zhaojie88
  6. 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  7. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1589305, encodeId=969a1589305af, content=<a href='/topic/show?id=fb0389e4373' target=_blank style='color:#2F92EE;'>#血管紧张素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89743, encryptionId=fb0389e4373, topicName=血管紧张素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5ce517702394, createdName=xiongliangxl, createdTime=Mon Oct 16 07:33:00 CST 2017, time=2017-10-16, status=1, ipAttribution=)]
    2017-10-16 lsj631
  8. [GetPortalCommentsPageByObjectIdResponse(id=1851544, encodeId=4d361851544b5, content=<a href='/topic/show?id=f0a254918f0' target=_blank style='color:#2F92EE;'>#抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Thu Jul 12 03:33:00 CST 2018, time=2018-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1935928, encodeId=dced193592861, content=<a href='/topic/show?id=6d06e826033' target=_blank style='color:#2F92EE;'>#经导管主动脉瓣植入#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78260, encryptionId=6d06e826033, topicName=经导管主动脉瓣植入)], attachment=null, authenticateStatus=null, createdAvatar=, 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1589305, encodeId=969a1589305af, content=<a href='/topic/show?id=fb0389e4373' target=_blank style='color:#2F92EE;'>#血管紧张素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89743, encryptionId=fb0389e4373, topicName=血管紧张素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5ce517702394, createdName=xiongliangxl, createdTime=Mon Oct 16 07:33:00 CST 2017, time=2017-10-16, status=1, ipAttribution=)]
    2017-10-16 heli0118
  9. [GetPortalCommentsPageByObjectIdResponse(id=1851544, encodeId=4d361851544b5, content=<a href='/topic/show?id=f0a254918f0' target=_blank style='color:#2F92EE;'>#抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Thu Jul 12 03:33:00 CST 2018, time=2018-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1935928, encodeId=dced193592861, content=<a href='/topic/show?id=6d06e826033' target=_blank style='color:#2F92EE;'>#经导管主动脉瓣植入#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78260, encryptionId=6d06e826033, topicName=经导管主动脉瓣植入)], attachment=null, authenticateStatus=null, createdAvatar=, 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1589305, encodeId=969a1589305af, content=<a href='/topic/show?id=fb0389e4373' target=_blank style='color:#2F92EE;'>#血管紧张素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89743, encryptionId=fb0389e4373, topicName=血管紧张素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5ce517702394, createdName=xiongliangxl, createdTime=Mon Oct 16 07:33:00 CST 2017, time=2017-10-16, status=1, ipAttribution=)]
    2017-10-16 slcumt
  10. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1589305, encodeId=969a1589305af, content=<a href='/topic/show?id=fb0389e4373' target=_blank style='color:#2F92EE;'>#血管紧张素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89743, encryptionId=fb0389e4373, topicName=血管紧张素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5ce517702394, createdName=xiongliangxl, createdTime=Mon Oct 16 07:33:00 CST 2017, time=2017-10-16, status=1, ipAttribution=)]

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