Doppler echocardiography aortic stenosis cardiac amyloidosis heart failure surgical aortic valve replacement tafamidis transcatheter aortic valve replacement transthyretin
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摘要

The prevalence of calcific aortic stenosis (AS) and of cardiac amyloidosis (CA) increases with age, and their association is not uncommon in the elderly. The identification of CA is particularly challenging in patients with AS because these 2 conditions share several features. It is estimated that ≤15% of the AS population and ≤30% of the subset with low-flow, low-gradient pattern may have CA. In patients with AS, CA is associated with increased risk of heart failure, mortality, and treatment futility with aortic valve replacement. In case of suspicion of CA, it is thus crucial to confirm the diagnosis to guide therapeutic management of AS and eventually implement recently developed pharmacological treatment dedicated to transthyretin amyloidosis. Given the high surgical risk of patients with AS and concomitant CA, transcatheter aortic valve replacement may be preferred to surgery in these patients.

译文

钙化性主动脉瓣狭窄 (AS) 和心脏淀粉样变 (CA) 的患病率随着年龄的增长而增加,它们的相关性在老年人中并不少见。在 AS 患者中识别 CA 尤其具有挑战性,因为这两种情况具有几个共同特征。据估计,≤ 15% 的 AS 总体和 ≤ 30% 的具有低流量、低梯度模式的子集可能具有 CA。在 AS 患者中,CA 与心脏衰竭、死亡率和主动脉瓣置换治疗无效的风险增加有关。因此,在怀疑 CA 的情况下,确认诊断以指导 AS 的治疗管理是至关重要的,并最终实施最近开发的专门用于转甲状腺素淀粉样变的药物治疗。鉴于患有 AS 和伴随 CA 的患者手术风险高,在这些患者中,经导管主动脉瓣置换可能比手术更受欢迎。

aortic stenosis

心血管 主动脉 疾病
概述  :  

主动脉瓣狭窄(AS)最常见的病因是风湿性心脏病、先天性畸形、老年钙化性(退行性变),梗阻的部位可能在瓣膜、瓣膜上或瓣膜下。主动脉瓣狭窄时左心室向升主动脉射血时常会发生梗阻。风湿性炎症引起的单纯性主动脉瓣狭窄少见,大多伴有不同程度的主动脉关闭不全和二尖瓣狭窄。已诊断为此病的病人除无症状、病变较轻者外,多数需要手术治疗。出现充血性心力衰竭、晕厥和心绞痛等症状的病人自然生存期较短。病理生理正常成人主动脉瓣口面积3-4 cm2。主动脉瓣口面积减少至正常1/3前血流动力学改变不明显。当主动脉瓣口面积≤

Aortic 英 [eɪ'ɔːtɪk]  美 [e'ɔrtɪk] 

释    义   adj. 大动脉的

短    语   aortic dissection 主动脉夹层

aortic valve 主动脉瓣;织脉瓣


Stenosis 英 [stɪ'nəʊsɪs]  美 [stɪ'nosɪs] 

释    义   n. (器官)[病理] 狭窄

短    语   mitral stenosis 二尖瓣狭窄

pulmonary stenosis [医]肺动脉瓣狭窄

同根词   词根: stenosed

adj. stenosed 狭窄的;患狭窄症的  stenotic 狭窄的

例    句   To investigate the relationship between the length of the right coronary artery and coronary stenosis.

研究右冠状动脉的长度和其发生冠状动脉狭窄的关系。


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