Effects of percutaneous coronary intervention on cardiac function in patients with chronic total occlusion lesions
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摘要: 目的:观察行经皮冠状动脉介入(PCI)治疗成功开通慢性完全闭塞(CTO)病变是否能改善患者的心脏功能。方法:回顾性纳入我院2016年1月—2018年1月行冠状动脉造影证实单支CTO病变且接受PCI治疗的患者132例,根据CTO是否开通,将所纳入患者分为开通组(70例)和未开通组(62例)。收集患者的基本临床资料,记录并比较随访期间院外主要不良心脑血管事件(MACCE)、心功能NYHA分级、左室射血分数(LVEF)、左心室舒张末期内径(LVEDD)等。结果:随访1年,未开通组和开通组在心功能NYHA分级、LVEF[(53.56±8.93)%∶(62.83±8.94)%]、LVEDD[(51.69±5.10) mm∶(48.60±5.51) mm]、全因死亡率(11.3%∶1.4%)、再次血运重建率(19.4%∶7.1%)和总MACCE发生率(40.3%∶11.4%)方面差异均具有统计学意义(均P<0.05)。结论:CTO开通能够改善患者左室功能、优化心室肌重构,降低MACCE的发生率。Abstract: Objective: To observe whether the successful opening of CTO lesions by percutaneous coronary intervention(PCI) can improve the cardiac function.Methods: A total of 132 patients with single CTO lesion confirmed by coronary angiography and received PCI treatment from January 2016 to January 2018 were retrospectively included and divided into CTO-enabled group(n=70) and CTO-disabled group(n=62). The basic clinical data were collected and the follow-up results such as major adverse cardiovascular and cerebrovascular events(MACCE), heart function(NYHA grade), left ventricular ejection fraction(LVEF), and left ventricular end diastolic diameter(LVEDD) were recorded.Results: After a one-year follow-up, there were significant differences in NYHA grade, LVEF([53.56±8.93]% vs [62.83±8.94]%), LVEDD([51.69±5.10]mm vs [48.60±5.51]mm), all-cause mortality(11.3% vs 1.4%), revascularization rate(19.4% vs 7.1%), and total MACCE incidence(all P<0.05).Conclusion: CTO opening can improve left ventricular function, optimize ventricular remodeling, and reduce the incidence of MACCE.
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