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On-line Access: 2021-03-12

Received: 2020-08-10

Revision Accepted: 2020-12-09

Crosschecked: 2021-02-23

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Citations:  Bibtex RefMan EndNote GB/T7714

 ORCID:

Jiaqi FAN

https://orcid.org/0000-0002-1909-9026

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Journal of Zhejiang University SCIENCE B 2021 Vol.22 No.3 P.241-247

http://doi.org/10.1631/jzus.B2000431


Kidney function change after transcatheter aortic valve replacement in patients with diabetes and/or hypertension


Author(s):  Jiaqi FAN, Changjie YU, Kaida REN, Wanbing LIN, Stella NG, Zexin CHEN, Xinping LIN, Lihan WANG, Qifeng ZHU, Yuxin HE, Jubo JIANG, Xianbao LIU, Jian'an WANG

Affiliation(s):  Department of Cardiology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China; more

Corresponding email(s):   wangjianan111@zju.edu.cn, liuxb@zju.edu.cn

Key Words: 


Jiaqi FAN, Changjie YU, Kaida REN, Wanbing LIN, Stella NG, Zexin CHEN, Xinping LIN, Lihan WANG, Qifeng ZHU, Yuxin HE, Jubo JIANG, Xianbao LIU, Jian'an WANG. Kidney function change after transcatheter aortic valve replacement in patients with diabetes and/or hypertension[J]. Journal of Zhejiang University Science B, 2021, 22(3): 241-247.

@article{title="Kidney function change after transcatheter aortic valve replacement in patients with diabetes and/or hypertension",
author="Jiaqi FAN, Changjie YU, Kaida REN, Wanbing LIN, Stella NG, Zexin CHEN, Xinping LIN, Lihan WANG, Qifeng ZHU, Yuxin HE, Jubo JIANG, Xianbao LIU, Jian'an WANG",
journal="Journal of Zhejiang University Science B",
volume="22",
number="3",
pages="241-247",
year="2021",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B2000431"
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%T Kidney function change after transcatheter aortic valve replacement in patients with diabetes and/or hypertension
%A Jiaqi FAN
%A Changjie YU
%A Kaida REN
%A Wanbing LIN
%A Stella NG
%A Zexin CHEN
%A Xinping LIN
%A Lihan WANG
%A Qifeng ZHU
%A Yuxin HE
%A Jubo JIANG
%A Xianbao LIU
%A Jian'an WANG
%J Journal of Zhejiang University SCIENCE B
%V 22
%N 3
%P 241-247
%@ 1673-1581
%D 2021
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B2000431

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A1 - Jiaqi FAN
A1 - Changjie YU
A1 - Kaida REN
A1 - Wanbing LIN
A1 - Stella NG
A1 - Zexin CHEN
A1 - Xinping LIN
A1 - Lihan WANG
A1 - Qifeng ZHU
A1 - Yuxin HE
A1 - Jubo JIANG
A1 - Xianbao LIU
A1 - Jian'an WANG
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PB - Zhejiang University Press & Springer
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DOI - 10.1631/jzus.B2000431


Abstract: 
Aortic stenosis (AS) is a progressive heart valve disease occurring predominantly in older patients. According to a survey in a western country, the prevalence of AS is nearly 6.4% in patients over 75 years old (Carabello and Paulus, 2009). Transcatheter aortic valve replacement (TAVR) is an alternative method for AS patients. Previous studies have described how up to 66% of TAVR patients have concomitant baseline kidney dysfunction (Ferro et al., 2015; Gargiulo et al., 2015). The majority of patients can benefit from the TAVR procedure with the recovery of kidney function. The TAVR procedure releases the obstruction of the left ventricle caused by severe AS, and the increased cardiac output may be reasonably responsible for recovery of the kidney function (Ewe et al., 2010; Dauerman et al., 2016). Kidney dysfunction is most commonly attributed to diabetes and hypertension (HTN) (Chen et al., 2019). A few studies have reported kidney function change after TAVR in baseline chronic kidney disease (CKD) patients (Beohar et al., 2017; Azarbal et al., 2019; Okoh et al., 2019). However, no study has focused on kidney function change after TAVR in the diabetic or hypertensive population. Therefore, we aimed to investigate kidney function change during the TAVR procedure in patients with diabetes mellites (DM) and/or HTN.

糖尿病和(或)高血压患者经导管主动脉瓣置换术后肾功能改变研究

目的:探究糖尿病和(或)高血压患者行经导管主动脉瓣置换术后肾功能的改变情况,影响因素及对预后的影响。
创新点:探索糖尿病和(或)高血压患者行经导管主动脉瓣置换术后肾功能的变化及影响因素,这为部分患者术后肾功能变化提供临床管理依据。
方法:纳入242例重度主动脉瓣狭窄行经导管主动脉瓣置换术的糖尿病和(或)高血压患者,根据出院前估算肾小球滤过率(eGFR)与基线eGFR变化百分比分为3组:肾功能恢复组、肾功能无变化组以及肾功能恶化组。比较3组之间的临床基线数据和预后数据,并探索对术后肾功能改变的影响因素。
结论:结果发现,肾功能无变化组有更低的美国胸外科医师协会(STS)评分和更少的外周血管疾病合并症。肾功能改善组有更低的基线eGFR值、更低的左心室射血分数(LVEF)。肾功能恶化组住院期间和30天随访的死亡率均更高。肾功能改变的独立预测因素包括术前STS、LVEF、基线eGFR和预料外的体外循环发生率。在糖尿病和(或)高血压患者中,有接近40%的患者在经导管主动脉瓣置换术后肾功能得到改善。而肾功能恶化预示着更坏的临床结局。

关键词:经导管主动脉瓣置换术;肾功能改变;高血压;糖尿病

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article

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