PDF(Pubmed)
Abstract：
UNASSIGNED: Rheumatic heart disease (RHD) is a critical problem in developing countries and is the cause of most of the cardiovascular adverse events in young people. In patients aged 50-70 years with RHD requiring mitral valve replacement (MVR), deciding between bioprosthetic and mechanical prosthetic valves remains controversial because few studies have defined the long-term outcomes.
UNASSIGNED: 1,691 Patients aged 50-70 years with RHD who received mechanical mitral valve replacement (MVRm) or bioprosthetic mitral valve replacement (MVRb) were retrospectively reviewed in Fuwai hospital from 2010 to 2014. Follow-up ended 31/12/2021; median duration was 8.0 years [interquartile range (IQR), 7.7-8.3 years]. Propensity score matching at a 1:1 ratio for 24 baseline features between MVRm and MVRb yielded 300 patient pairs. The primary late outcome was postoperative mid- to long-term all-cause mortality.
UNASSIGNED: Ten-year survival after MVR was 63.4% in the MVRm group and 63.7% in the MVRb group (HR, 0.91; 95% CI, 0.69-1.21; P = 0.528). The cumulative incidence of mitral valve reoperation was 0.0% in the MVRm group and 1.2% in the MVRb group (HR, 0.92; 95% CI, 0.69-1.21; P = 0.530). The cumulative incidence of stroke was 5.5% in the MVRm group and 6.1% in the MVRb group (HR, 0.89; 95% CI, 0.67-1.18; P = 0.430). The cumulative incidence of major bleeding events was 3.3% in the MVRm group and 3.4% in the MVRb group (HR, 0.92; 95% CI, 0.70-1.22; P = 0.560).
UNASSIGNED: In patients aged 50-70 years with RHD who underwent mitral valve replacement, there was no significant difference on survival, stroke, mitral valve reoperation and major bleeding events at 10 years. These findings suggest mechanical mitral valve replacement may be a more reasonable alternative in patients aged 50-70 years with rheumatic heart disease.
UNASSIGNED: 1,691 Patients aged 50-70 years with RHD who received mechanical mitral valve replacement (MVRm) or bioprosthetic mitral valve replacement (MVRb) were retrospectively reviewed in Fuwai hospital from 2010 to 2014. Follow-up ended 31/12/2021; median duration was 8.0 years [interquartile range (IQR), 7.7-8.3 years]. Propensity score matching at a 1:1 ratio for 24 baseline features between MVRm and MVRb yielded 300 patient pairs. The primary late outcome was postoperative mid- to long-term all-cause mortality.
UNASSIGNED: Ten-year survival after MVR was 63.4% in the MVRm group and 63.7% in the MVRb group (HR, 0.91; 95% CI, 0.69-1.21; P = 0.528). The cumulative incidence of mitral valve reoperation was 0.0% in the MVRm group and 1.2% in the MVRb group (HR, 0.92; 95% CI, 0.69-1.21; P = 0.530). The cumulative incidence of stroke was 5.5% in the MVRm group and 6.1% in the MVRb group (HR, 0.89; 95% CI, 0.67-1.18; P = 0.430). The cumulative incidence of major bleeding events was 3.3% in the MVRm group and 3.4% in the MVRb group (HR, 0.92; 95% CI, 0.70-1.22; P = 0.560).
UNASSIGNED: In patients aged 50-70 years with RHD who underwent mitral valve replacement, there was no significant difference on survival, stroke, mitral valve reoperation and major bleeding events at 10 years. These findings suggest mechanical mitral valve replacement may be a more reasonable alternative in patients aged 50-70 years with rheumatic heart disease.
摘要：
风湿性心脏病（RHD）在发展中国家是一个严重的问题，也是大多数年轻人心血管不良事件的原因。在需要二尖瓣置换术（MVR）的50-70岁RHD患者中，在生物人工瓣膜和机械人工瓣膜之间的决定仍然存在争议,因为很少有研究确定长期结局.
■2010年至2014年在阜外医院接受机械二尖瓣置换术（MVRm）或生物假体二尖瓣置换术（MVRb）的1,691例年龄在50-70岁的RHD患者进行回顾性分析。随访结束于2021年12月31日；中位持续时间为8.0年[四分位距（IQR），7.7-8.3年]。对于MVRm和MVRb之间的24个基线特征以1:1比率匹配的倾向评分产生了300个患者对。主要的晚期结局是术后中长期全因死亡率。
■MVR后的十年生存率在MVRm组为63.4％，在MVRb组为63.7％（HR，0.91；95%CI，0.69-1.21；P=0.528）。二尖瓣再手术的累积发生率在MVRm组为0.0%,在MVRb组为1.2%(HR,0.92；95%CI，0.69-1.21；P=0.530）。在MVRm组中，卒中的累积发生率为5.5％，在MVRb组中为6.1％（HR，0.89；95%CI，0.67-1.18；P=0.430）。主要出血事件的累积发生率在MVRm组为3.3%,在MVRb组为3.4%(HR,0.92；95%CI，0.70-1.22；P=0.560）。
■在50-70岁接受二尖瓣置换术的RHD患者中，生存率没有显着差异，中风,10年二尖瓣再手术和大出血事件。这些发现表明，对于50-70岁的风湿性心脏病患者，机械二尖瓣置换术可能是更合理的选择。
■2010年至2014年在阜外医院接受机械二尖瓣置换术（MVRm）或生物假体二尖瓣置换术（MVRb）的1,691例年龄在50-70岁的RHD患者进行回顾性分析。随访结束于2021年12月31日；中位持续时间为8.0年[四分位距（IQR），7.7-8.3年]。对于MVRm和MVRb之间的24个基线特征以1:1比率匹配的倾向评分产生了300个患者对。主要的晚期结局是术后中长期全因死亡率。
■MVR后的十年生存率在MVRm组为63.4％，在MVRb组为63.7％（HR，0.91；95%CI，0.69-1.21；P=0.528）。二尖瓣再手术的累积发生率在MVRm组为0.0%,在MVRb组为1.2%(HR,0.92；95%CI，0.69-1.21；P=0.530）。在MVRm组中，卒中的累积发生率为5.5％，在MVRb组中为6.1％（HR，0.89；95%CI，0.67-1.18；P=0.430）。主要出血事件的累积发生率在MVRm组为3.3%,在MVRb组为3.4%(HR,0.92；95%CI，0.70-1.22；P=0.560）。
■在50-70岁接受二尖瓣置换术的RHD患者中，生存率没有显着差异，中风,10年二尖瓣再手术和大出血事件。这些发现表明，对于50-70岁的风湿性心脏病患者，机械二尖瓣置换术可能是更合理的选择。
