在医生指导下,患者在晚期慢性心力衰竭中对左心房压的自我管理
Jay Ritzema1, Richard Troughton, Iain Melton
1University of Otago, Christchurch, New Zealand.
Circulation
|February 24, 2010
概括
在医生的指导下,患者对左心房压的自我管理改善了心力衰竭的结果. 这种系统减少了脱补偿事件,改善了高级心力衰竭患者的血液动力学,症状和药物管理.
科学领域:
- 心脏病学 心脏病学
- 生物医学工程 生物医学工程
- 临床研究 临床研究
背景情况:
- 门诊血液动力学监测可以提高慢性心力衰竭的管理.
- 研究了一种针对左心房压力的新型医生指导的患者自我管理系统.
研究的目的:
- 评估患者自我管理系统对晚期心力衰竭中左心房压的疗效.
- 评估医生指导的,压力导向治疗对心力衰竭结果的影响.
主要方法:
- 一项前性,观察性,首次在人体上进行的研究,涉及40名心力衰竭患者.
- 植入一个实验性的左心房压监测仪,每天读数两次.
- 盲目监测3个月,随后向患者披露压力引导治疗.
主要成果:
- 在3年后,无事件生存率为61%,在压力引导治疗开始后发生的事件较少 (HR 0.16,P=0.012).
- 平均左心房压明显下降 (17.6~14.8毫米平;P=0.003),高读数下降67% (P<0.001).
- 在纽约心脏协会的类别 (-0.7,P<0.001) 和左心室喷射率 (+7%,P<0.001) 中观察到的改善,随着药物升级.
结论:
- 在医生指导下,患者对左心房压的自我管理,有望改善血液动力学和晚期心力衰竭的结果.
- 这种方法可能会导致更好的症状控制和减少住院治疗.
- 需要进一步的临床试验来证实这些发现.
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