在心脏植入式电子设备和心力衰竭患者中,个性化反应率编程在6个月后提高了运动耐受性:一项II期研究
John Gierula1, Judith E Lowry1, Maria F Paton1
1Leeds Institute of Cardiovascular and Metabolic Medicine (J.G., J.E.L., M.F.P., C.A.C., R.B., A.O.K., H.C., L.C.K., S.S., R.M.C., M.T.K., K.K.W.), University of Leeds, United Kingdom.
Circulation
|April 18, 2020
概括
使用力频关系 (FFR) 数据来定制心脏器件编程,改善了心力衰竭患者的运动时间. 这种以FFR为指导的方法也在六个月内保持了左心室功能.
科学领域:
- 心脏病学
- 生物医学工程
背景情况:
- 减少喷射分数 (HFrEF) 的心力衰竭与弱的力频率关系 (FFR) 有关,影响左心室 (LV) 的收缩性.
- 之前的研究表明,根据FFR数据进行量身定制的心脏器件编程,HFrEF患者的急性运动能力得到改善.
研究的目的:
- 评估心脏植入式电子设备的HFrEF患者的FFR指导率-响应编程是否改善了运动能力和六个月后的LV功能.
- 将FFR导向编程与传统的年龄导向编程进行比较.
主要方法:
- 一个单中心,双盲,随机试验,涉及心脏植入式电子设备 (起器或除器) 的HFrEF患者.
- 参与者被随机分配到以FFR为导向的或以年龄为导向的常规速率-反应编程中.
- 主要结局是跑步机行走测试时间的变化;次要结局包括 LV 缩功能,峰值氧气消耗和生活质量.
主要成果:
- 在6个月后,与常规步伐 (3.1秒) 相比,FFR引导步伐显著增加了运动时间 (75.4秒) (P=0.044).
- 尽管FFR指导组心率峰值较低,但LV结构和功能保持稳定.
- 常规设置与LV喷射分数的降低有关.
结论:
- 在使用心脏器械的HFrEF患者中,FFR指导的速度-反应编程可增加运动时间并保持LV功能.
- 非侵入性FFR方法是可重现的,有利于优化设备设置.
- 需要进一步的多中心研究来证实长期的临床结果.
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