用连续流动左心室辅助装置和药理疗法逆转严重心力衰竭:一项前性研究
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
概括
机械支持和药物治疗的结合可以导致非缺血性心肌病症患者的显著心肌恢复,允许左心室辅助装置的移除和改善心脏功能.
科学领域:
- 心脏病学 心脏病学
- 机械循环支持 机械循环支持
- 药理疗法 药理疗法 药理疗法
背景情况:
- 之前的研究表明,通过脉动器件和药物治疗,心肌恢复.
- 此前没有对非脉冲性左心室辅助器件进行评估.
研究的目的:
- 在使用非脉动左心室辅助器件的非缺血性心肌病患者中研究联合机械和药理疗法的疗效.
- 评估心肌恢复和器件扩张的潜力.
主要方法:
- 对20名患有非缺血性心肌病的患者进行前性研究,这些患者接受非脉动左心室辅助装置.
- 组合疗法包括ACE抑制剂,β抑制剂,血管激素II抑制剂,阿尔多激素对抗剂和克伦布托罗尔.
- 患者定期接受检查,包括心声图,运动测试和低速度的导管.
主要成果:
- 在19名符合条件的患者中,12名 (63.2%) 在平均支持持续时间为286天后成功进行了探索.
- 移植前的评估显示,喷射分数 (70%) 显著改善,肺毛细管压力降低 (5.9 mm Hg).
- 心力衰竭没有复发的估计存活率在移植后1年和3年为83.3%.
结论:
- 与机械卸载和药理学药物的联合治疗可以逆转非缺血性心肌病的末期心力衰竭.
- 这种方法在很大一部分患者中促进了左心室辅助器件的探索.
- 在这种治疗策略中,可以有效地利用非脉冲器械.
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