PDF(Pubmed)
Abstract：
UNASSIGNED: There is a paucity of data on long-term outcomes after Fontan palliation in patients with a dominant morphological univentricular right (uRV) vs left (uLV) ventricle.
UNASSIGNED: The purpose of this study was to compare the incidence of atrial arrhythmias, thromboembolic events, cardiac transplantation, and death following Fontan palliation in patients with uRV vs uLV.
UNASSIGNED: The Alliance for Adult Research in Congenital Cardiology conducted a multicenter retrospective cohort study on patients with total cavopulmonary connection Fontan palliation across 12 centers in North America. All components of the composite outcome, that is, atrial arrhythmias, thromboembolic events, cardiac transplantation, and death, were reviewed and classified by a blinded adjudicating committee. Time-to-event analyses were performed that accounted for competing risks.
UNASSIGNED: A total of 384 patients were followed for 10.5 ± 5.9 years. The composite outcome occurred in 3.7 vs 1.7 cases per 100 person-years for uRV (N = 171) vs uLV (N = 213), respectively (P < 0.001). In multivariable analyses, uRV conferred a >2-fold higher risk of the composite outcome (HR: 2.17, 95% CI: 1.45-3.45, P < 0.001). In secondary analyses of components of the primary outcome, uRV was significantly associated with a greater risk of cardiac transplantation or death (HR: 9.09, 95% CI: 2.17-38.46, P < 0.001) and atrial arrhythmias (HR: 2.17, 95% CI: 1.20-4.00, P = 0.010) but not thromboembolic events (HR: 1.64, 95% CI: 0.86-3.16, P = 0.131).
UNASSIGNED: Fontan patients with uRV vs uLV morphology have a higher incidence of adverse cardiovascular events, including atrial arrhythmia, cardiac transplantation, and all-cause mortality.
UNASSIGNED: The purpose of this study was to compare the incidence of atrial arrhythmias, thromboembolic events, cardiac transplantation, and death following Fontan palliation in patients with uRV vs uLV.
UNASSIGNED: The Alliance for Adult Research in Congenital Cardiology conducted a multicenter retrospective cohort study on patients with total cavopulmonary connection Fontan palliation across 12 centers in North America. All components of the composite outcome, that is, atrial arrhythmias, thromboembolic events, cardiac transplantation, and death, were reviewed and classified by a blinded adjudicating committee. Time-to-event analyses were performed that accounted for competing risks.
UNASSIGNED: A total of 384 patients were followed for 10.5 ± 5.9 years. The composite outcome occurred in 3.7 vs 1.7 cases per 100 person-years for uRV (N = 171) vs uLV (N = 213), respectively (P < 0.001). In multivariable analyses, uRV conferred a >2-fold higher risk of the composite outcome (HR: 2.17, 95% CI: 1.45-3.45, P < 0.001). In secondary analyses of components of the primary outcome, uRV was significantly associated with a greater risk of cardiac transplantation or death (HR: 9.09, 95% CI: 2.17-38.46, P < 0.001) and atrial arrhythmias (HR: 2.17, 95% CI: 1.20-4.00, P = 0.010) but not thromboembolic events (HR: 1.64, 95% CI: 0.86-3.16, P = 0.131).
UNASSIGNED: Fontan patients with uRV vs uLV morphology have a higher incidence of adverse cardiovascular events, including atrial arrhythmia, cardiac transplantation, and all-cause mortality.
摘要：
■右心室（uRV）与左心室（uLV）占优势的患者在Fontan姑息治疗后的长期结局数据很少。
■这项研究的目的是比较房性心律失常的发生率，血栓栓塞事件,心脏移植,uRV与uLV患者Fontan姑息治疗后死亡。
■成人先天性心脏病学研究联盟在北美12个中心对全腔肺动脉连接Fontan缓解患者进行了一项多中心回顾性队列研究。综合结果的所有组成部分，也就是说,房性心律失常,血栓栓塞事件,心脏移植,和死亡,由一个盲目的裁决委员会进行审查和分类。进行了考虑竞争风险的时间至事件分析。
■共384例患者随访10.5±5.9年。uRV（N=171）与uLV（N=213）的复合结局分别为每100人年3.7例和1.7例，分别(P<0.001)。在多变量分析中，uRV赋予复合结局的风险>2倍(HR:2.17,95%CI:1.45-3.45,P<0.001)。在主要结果成分的次要分析中，uRV与心脏移植或死亡风险(HR:9.09,95%CI:2.17-38.46,P<0.001)和房性心律失常(HR:2.17,95%CI:1.20-4.00,P=0.010)显著相关,但与血栓事件无关(HR:1.64,95%CI:0.86-3.16,P=0.131)。
■uRV与uLV形态的Fontan患者有较高的不良心血管事件发生率，包括房性心律失常,心脏移植,和全因死亡率。
■这项研究的目的是比较房性心律失常的发生率，血栓栓塞事件,心脏移植,uRV与uLV患者Fontan姑息治疗后死亡。
■成人先天性心脏病学研究联盟在北美12个中心对全腔肺动脉连接Fontan缓解患者进行了一项多中心回顾性队列研究。综合结果的所有组成部分，也就是说,房性心律失常,血栓栓塞事件,心脏移植,和死亡,由一个盲目的裁决委员会进行审查和分类。进行了考虑竞争风险的时间至事件分析。
■共384例患者随访10.5±5.9年。uRV（N=171）与uLV（N=213）的复合结局分别为每100人年3.7例和1.7例，分别(P<0.001)。在多变量分析中，uRV赋予复合结局的风险>2倍(HR:2.17,95%CI:1.45-3.45,P<0.001)。在主要结果成分的次要分析中，uRV与心脏移植或死亡风险(HR:9.09,95%CI:2.17-38.46,P<0.001)和房性心律失常(HR:2.17,95%CI:1.20-4.00,P=0.010)显著相关,但与血栓事件无关(HR:1.64,95%CI:0.86-3.16,P=0.131)。
■uRV与uLV形态的Fontan患者有较高的不良心血管事件发生率，包括房性心律失常,心脏移植,和全因死亡率。
