背景:本研究的目的是调查发病率,潜在风险因素,在接受Watchman左心耳封堵术(LAAC)的房颤(AF)患者中,器械内皮化(IDE)不全的临床结果。
方法:在本研究中,68例房颤患者在随访期间成功植入Watchman装置而无装置周围渗漏(PDL)。在植入后6周和6个月,使用经食管超声心动图(TEE)和LAA计算机断层扫描血管造影(CTA)评估内皮化状态。在一年的随访中记录了不良的脑心事件。基线特征,包括年龄,设备尺寸,和临床指标,被分析为IDE的潜在预测因子。
结果:在植入后6周和6个月,在70.6%和67.6%的患者中观察到IDE,分别。较高水平的高密度脂蛋白胆固醇(HDL-C)[比值比(OR):15.109,95%置信区间(CI):1.637-139.478,p=0.017和OR:11.015,95%CI:1.365-88.896,p=0.024]和较低的天冬氨酸氨基转移酶(AST)(OR0.924,95CI:0.865:0.886)在基线时间为0.017-0.93%分别,尽管在1年随访期间,不完全和完全DE组之间的不良脑心事件没有显著差异。结论:发现IDE在LAAC后的人类中普遍存在.HDL-C水平升高和AST水平降低显示与LAAC后IDE风险增加有关。
BACKGROUND: The objective of this study is to investigate the incidence, potential risk factors, and clinical outcomes of incomplete device endothelialization (IDE) in atrial fibrillation (AF) patients undergoing Watchman left atrial appendage closure (LAAC).
METHODS: In this study, 68 AF patients who underwent successful implantation of the Watchman device without peri-device leak (PDL) during follow-up were included. The endothelialization status was assessed using Transesophageal echocardiography (TEE) and LAA computed tomography angiography (CTA) at 6 weeks and 6 months post-implantation. Adverse cerebro-cardiac events were documented at one-year follow-up. Baseline characteristics, including age, device sizes, and clinical indicators, were analyzed as potential predictors for IDE.
RESULTS: IDE was observed in 70.6% and 67.6% of patients at 6 weeks and 6 months after implantation, respectively. Higher levels of high-density lipoprotein cholesterol (HDL-C) [odds ratio (OR): 15.109, 95% confidence interval (CI): 1.637-139.478, p = 0.017 and OR: 11.015, 95% CI: 1.365-88.896, p = 0.024] and lower aspartate aminotransferase (AST) (OR 0.924, 95% CI: 0.865-0.986, p = 0.017 and OR: 0.930, 95% CI: 0.874-0.990, p = 0.023) at baseline were found to be significantly associated with IDE at 6 weeks and 6 months, respectively, although no significant difference in adverse cerebro-cardiac events was noted between incomplete and complete DE groups during 1-year follow-up CONCLUSIONS: IDE is found to be a prevalent occurrence in humans following LAAC. Elevated HDL-C and reduced AST levels are shown to be linked to an increased risk of IDE after LAAC.