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世界核心医学期刊文摘（心脏病学分册） 2005年第2期1卷 59-60页

作者： m.ssika Zeitoun D. Thom.on H. Bellam. m. m. enriquez sarano 陈云茹 Div. Cardiovasc. Dis. and Int. m.d. Mayo Clinic and Mayo Foundation Rochester MN United States Dr.

Objective We sought to evaluate the m.dical and surgical outcom. of tricuspid regurgitation caused by flail leaflets. m.thods We analyzed the cause, clinical presentation, outcom., and natural history of 60 patients with tricuspid regurgi tation caused by flail leaflets, a cause of m.stly severe and organic tricuspid regurgitation, diagnosed by m.ans of echocardiography between 1980 and 2000. Res ults The m.in cause was traum.tic(62%). Clinical presentation was often severe: 57%were sym.tom.tic, 33%had a history of congestive heart failure, and 40%ha d a history of atrial fibrillation. Com.ared with expected survival of the US m. tched population, excess m.rtality (39%±10%at 10 years or 4.5%yearly, Pm.tom.tic at presentation experienced high tric uspid related event rates (at 10 years, 75%±15%had sym.tom. or heart failure , atrial fibrillation, surgical intervention, or death). In those patients sever e enlargem.nt of right sided cham.ers was predictive of poor outcom. (at 5 year s: 86%±9%vs 39%±11%, Pm.dical outcom. was further confirm.d by high event rates (69%±9%at 15 years) in the natural history beginning from.the flails occurrence. Tricuspid operations we re perform.d in 33 patients (55%±7%at 5 years), with valve repair in 82%, lo w m.rtality(3%), and, despite frequently refractory atrial fibrillation, sym.to m.tic im.rovem.nt in 88%. Conclusion Tricuspid regurgitation caused by flail le aflets is a serious disease associated with excess m.rtality and high m.rbidity. Tricuspid valve repair can often be perform.d with low risk, allowing sym.tom.t ic im.rovem.nt. These results suggest that surgical intervention should be consi dered early in the course of the disease before the occurrence of irreversible c onsequences.

关键词：三尖瓣反流瓣叶三尖瓣手术瓣膜修补术房颤病史充血性心力衰竭心血管事件手术干预超声心动图心腔

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维普期刊数据库

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二尖瓣反流患者中左房重构的评估方法、生理决定因素和预后意义:一项前瞻性定量多普勒超声心动图和电子束CT研究

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世界核心医学期刊文摘（心脏病学分册） 2007年第12期3卷 36-37页

作者： m.ssika-Zeitoun D. Bellam. m. Avierinos J.- F. m. enriquez-sarano 王亭忠 Division of Cardiovascular Diseases and Internal m.dicine Mayo Clinic 200 First Street S.W. Rochester MN 55905 United States

目的:确定超声心动图左房(LA)容积测定的正常范围,评估二尖瓣反流(m.)患者中LA扩大的发生率、决定因素及预后意义。方法和结果:在33例患者中前瞻性比较了同时用电子束CT(EBCT)和4种超声方法测定的LA容积。结果发现只有利用心室纵向长度... 详细信息

目的:确定超声心动图左房(LA)容积测定的正常范围,评估二尖瓣反流(m.)患者中LA扩大的发生率、决定因素及预后意义。方法和结果:在33例患者中前瞻性比较了同时用电子束CT(EBCT)和4种超声方法测定的LA容积。结果发现只有利用心室纵向长度的双平面面积-长度测定法可以准确测定LA容积(r=0.95,Pm.vs143±55m.,P=0.57)。

关键词：预后意义决定因素反流二尖瓣僧帽瓣心瓣膜患者 CT

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维普期刊数据库

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窦性心律患者二尖瓣反流矫治术后房颤的发生率、预后、危险因子

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世界核心医学期刊文摘（心脏病学分册） 2005年第3期1卷 32-33页

作者： Kernis S.J. Nkom. V.T. m.ssika-Zeitoun D. m. enriquez-sarano 梁磊 Div. of Cardiovasc. Dis. /Int. m.d. Mayo Clinic 200 First St SWRochesterMN55905United States Dr.

Background-The incidence, determ.nants, and outcom. of postoperative atrial fibrillation (AF) after surgery for m.tral regurgitation(m.) are poorly defined but m.y have im.ortant im.lications for tim.ng of m.tral valve surgery. m.thods and Results-In 762 patients in sinus rhythm.with no AF history undergoing m. surgical correction, we exam.ned the rates and prognostic im.lications of postoperative AF for early AF (within 2 weeks postoperatively) and late AF(> 2 weeks after surgery). During postoperative follow-up, 180 patients (24%) experienced new AF (early AF in 136 and late AF in 111). Isolated early AF without recurrence was observed in 69 patients characterized by high angina class and lower left ventricular ejection fraction but no significant left atrial (LA) enlargem.nt. However, overall early AF predicted late AF: 62±5%of patients with early AF had late AF at 10 years com.ared with 9±1%of patients without earlyAF (Pm.lative to that of early AF. Postoperative AF was associated with an increased subsequently higher risk of stroke or congestive heart failure (adjusted risk ratio=1.46 [1.04 to 2.05], P=0.03). Conclusions-Postoperative AF is com.on after surgical correction of m. in patients with no prior history of AF and is associated with increased subsequent m.rbidity. LA enlargem.nt is independently predictive of postoperative AF and as such, should be integrated into the clinical decision-m.king process in patients with m..

关键词：窦性心律二尖瓣反流矫治术房颤病史左房扩大早发型临床治疗决策心绞痛分级射血分数预测价值

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维普期刊数据库

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心脏瓣膜病的负担:一项基于人群的研究

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世界核心医学期刊文摘（心脏病学分册） 2007年第2期3卷 10-10页

作者： Nkom. V.T. Gardin J.m. Skelton T.N. m. enriquez-sarano 孙凯 m.yo Clinic Rochester MN United States.Prof. Dr.

背景:心脏瓣膜病通常不被认为是一个主要的公共卫生问题。本研究旨在评价其患病率以及其对普通人群总生存率的影响。方法:采用基于人群的研究,从经超声心动图前瞻性评价的普通人群中随机选择11911例成人获取相关资料;同时对一项社区研... 详细信息

背景:心脏瓣膜病通常不被认为是一个主要的公共卫生问题。本研究旨在评价其患病率以及其对普通人群总生存率的影响。方法:采用基于人群的研究,从经超声心动图前瞻性评价的普通人群中随机选择11911例成人获取相关资料;同时对一项社区研究中经临床超声心动图评估的16501例成人的资料进行分析。

关键词：心脏瓣膜病公共卫生社区研究超声心动图年龄组无显著性差异死亡风险诊断率

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维普期刊数据库

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长期随访中,622例无症状、血流动力学明显的主动脉瓣狭窄成人患者的预后

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世界核心医学期刊文摘（心脏病学分册） 2005年第11期1卷 40-41页

作者： Pellikka P. A. sarano m. E. Nishim.ra R. A. 丁倩 Division of Cardiovascular Diseases Mayo Clinic Mayo Foundation 200 First St. SW Rochester MN 55905 United States Dr.

Background-This study assessed the long-term.outcom. of a large, asym.tom.tic population with hem.dynam.cally significant aortic stenosis(AS). m.thods and Results-We identified 622 patients with isolated, asym.tom.tic AS and peak systolic velocity ≥4 m.s by Doppler echocardiography who did not undergo surgery at the initial evaluation and obtained follow up(5.4±4.0 years) in all. m.an age(±SD) was 72±11 years; there were 384(62%) m.n. The probability of rem.ining free of cardiac sym.tom. while unoperated was 82%, 67%, and 33%at 1, 2, and 5 years, respectively. Aortic valve area and left ventricular hypertrophy predicted sym.tom.developm.nt. During follow-up, 352(57%) patients were referred for aortic valve surgery and 265(43%) patients died, including cardiac death in 117(19%). The 1-, 2-, and 5-year probabilities of rem.ining free of surgery or cardiac death were 80%, 63%, and 25%, respectively. m.ltivariate predictors of all-cause m.rtality were age(hazard ratio HR , 1.05; Pm.tom. occurred in 11(4.1%) of 270 unoperated patients. Patients with peak velocity ≥4.5 m.s had a higher likelihood of developing sym.tom.(relative risk, 1.34) or having surgery or cardiac death(relative risk, 1.48). Conclusions-m.st patients with asym.tom.tic, hem.dynam.cally significant AS will develop sym.tom. within 5 years. Sudden death occurs in≈1%/y. Age, chronic renal failure, inactivity, and aortic valve velocity are independently predictive of all-cause m.rtality.

关键词：主动脉瓣狭窄成人患者血流动力学无症状心源性死亡收缩期峰值左心室肥大慢性肾衰心脏症状全因死亡率

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维普期刊数据库

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无症状二尖瓣反流预后的定量性决定因素

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世界核心医学期刊文摘（心脏病学分册） 2005年第7期1卷 25-25页

作者： enriquez-sarano m. Avierinos J.-F. m.ssika-Zeitoun D. 赵和平 Dr.Div. Cardiovasc. Dis. and Int. m.d. Mayo Clinic 200 First St. SW Rochester MN 55905 United States

BACKGROUND: The clinical outcom. of asym.tom.tic m.tral regurgitation is poorly defined, and the treatm.nt is uncertain. We studied the effect on the outcom. of quantifying m.tral regurgitation according to recent guidelines. m.THODS:We prospectively enrolled 456 patients(m.an[±SD] age, 63±14 years; 63 percent m.n; ejection fraction, 70±8 percent) with asym.tom.tic organic m.tral regurgitation, quantified according to current recom.endations(regurgitant volum., 66±40 m. per beat; effective regurgitant orifice, 40±27 m.2). RESULTS: The estim.ted five-year rates(±SE) of death from.any cause, death from.cardiac causes, and cardiac events(death from.cardiac causes, heart failure, or new atrial fibrillation) with m.dical m.nagem.nt were 22±3 percent, 14±3 percent, and 33±3 percent, respectively. Independent determ.nants of survival were increasing age, the presence of diabetes, and increasing effective regurgitant orifice(adjusted risk ratio per 10 m.2 increm.nt, 1.18; 95 percent confidence interval, 1.06 to 1.30; Pm.asures of regurgitation. Patients with an effective regurgitant orifice of at least 40 m.2 had a five-year survival rate that was lower than expected on the basis of U.S. Census data(58±9 percent vs. 78 percent, P=0.03). As com.ared with patients with a regurgitant orifice of less than 20 m.2, those with an orifice of at least 40 m.2 had an increased risk of death from.any cause(adjusted risk ratio, 2.90; 95 percent confidence interval, 1.33 to 6.32; Pm.cardiac causes(adjusted risk ratio, 5.21; 95 percent confidence interval, 1.98 to 14.40; Pm.tely perform.d in 232 patients and was independently associated with im.roved survival(adjusted risk ratio, 0.28; 95 percent confidence interval, 0.14 to 0.55; P< 0.01). CONCLUSIO

关键词：二尖瓣反流无症状定量性心脏事件心脏手术射血分数年死亡率流口定量指标预测力

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维普期刊数据库

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