重度の心不全の逆転は,継続的なフローの左心室補助装置と薬理学療法による:将来的な研究
Emma J Birks1, Robert S George, Mike Hedger
1Royal Brompton and Harefield NHS Foundation Trust, Harefield, Middlesex, UK. e.birks@imperial.ac.uk
Circulation
|January 19, 2011
まとめ
機械的サポートと薬物療法の組み合わせは,非乳房性心筋症候群の患者において,左心室補助装置の除去と心臓機能の改善を可能にする,重要な心筋回復につながる可能性があります.
科学分野:
- 心臓病学 心臓病学
- 機械的な循環器のサポート
- 薬理学療法薬理学療法とは
背景:
- 以前の研究では,脈動性デバイスと薬物療法によって心筋の回復が実証されました.
- このプロトコルは,以前,非脈動性左心室補助器具で評価されていませんでした.
研究 の 目的:
- 非脈動性左心室補助装置を用いた非血動性心筋病変症の患者における結合した機械療法と薬理学的療法の有効性を調査する.
- 心筋の回復と装置の拡張の可能性を評価する.
主な方法:
- 非脈動性左心室補助器官を受給している非血性心筋病変症の20人の患者を対象とした前向きな研究.
- 併用療法には,ACE阻害剤,β阻害剤,アンジオテンシンII阻害剤,アルドステロン抗剤,クレンブテロールが含まれていました.
- 患者は定期的な検査を受け,エコーカルジオグラム,運動検査,低ポンプ速度でのキャセテリゼーションなどを行いました.
主要な成果:
- 19人の適格な患者のうち12人 (63.2%) は,平均286日間のサポート期間を経て,成功しました.
- 移植前の評価では,エジェクション分数の有意な改善 (70%) と肺毛細血管の圧の低下 (5.9 mm Hg) が示されました.
- 心不全の再発のない推定生存率は,移植後1年と3年で83.3%でした.
結論:
- 機械的な卸荷と薬理学的薬剤を併用した併用療法により,非発血性心筋病の末期心不全を逆転させることができます.
- このアプローチは,患者のかなりの割合で左心室補助器具の検査を容易にする.
- 非脈動性器具は,この治療戦略において効果的に利用できます.
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