Evaluation of life cycle management system on patients'prognosis after transcatheter aortic valve replacement
10.3969/j.issn.1004-8812.2024.06.003
- VernacularTitle:评价全生命周期管理体系对经导管主动脉瓣置换术患者预后的影响
- Author:
Ruo-Yun LIU
1
,
2
;
Ran LIU
;
Mei-Fang DAI
;
Yue-Miao JIAO
;
Yang LI
;
San-Shuai CHANG
;
Ye XU
;
Zhi-Nan LU
;
Li ZHAO
;
Cheng-Qian YIN
;
Guang-Yuan SONG
Author Information
1. 北京体育大学运动人体科学学院,北京 100084
2. 首都医科大学附属北京安贞医院心脏瓣膜病介入中心,北京 100011
- Keywords:
Transcatheter aortic valve replacement;
Lifecycle management;
Heart multi-parameter monitoring;
Remote smart healthcare
- From:
Chinese Journal of Interventional Cardiology
2024;32(6):311-316
- CountryChina
- Language:Chinese
-
Abstract:
Objective With the widespread of transcatheter aortic valve replacement(TAVR)in patients with severe symptomatic aortic stenosis(AS),the life-cycle management has become a major determinant of prognosis.Methods A total of 408 AS patients who underwent successfully TAVR from June 2021 to August 2023 were consecutively enrolled in Hospital Valve Intervention Center.Patients were assigned to the Usual Care(UC)group between June 2021 and October 2022,while patients were assigned to the Heart Multi-parameter Monitoring(HMM)group between November 2022 and August 2023.The primary endpoint was defined as composite endpoint within 6 months post-TAVR,including all-cause death,cardiovascular death,stroke/transient ischemic attack,conduction block,myocardial infarction,heart failure rehospitalization,and major bleeding events.Secondary endpoints were the time interval(in hours)from event occurrence to medical consultation or advice and patient satisfaction.Statistical analysis was performed using Kaplan-Meier and multivariable Cox proportional hazards models.Results The incidence of primary endpoint in HMM group was significantly lower than that in UC group(8.9％vs.17.7％,P=0.016),the driving event was the rate of diagnosis and recognition of conduction block.The average time intervals from event occurrence to receiving medical advice were 3.02 h in HHM group vs.97.09 h in UC group(P＜0.001).Using cardiac monitoring devices and smart healthcare platforms provided significant improving in patients long-term management(HR 0.439,95％CI 0.244-0.790,P=0.006).Conclusions The utilization of cardiac monitoring devices and smart healthcare platforms effectively alerted clinical events and improved postoperative quality of life during long-term management post TAVR.
