跨吸管心室重塑可以减少功能性腹反,并改善心室功能在缺血性心肌病的临床前模型的心室功能
Chase L King1, Daisuke Onohara1, Stephanie K Tom1
1Structural Heart Research and Innovation Laboratory, Cardiothoracic Research Laboratories, Carlyle Fraser Heart Center at Emory University Hospital Midtown, Atlanta, Ga; Division of Cardiothoracic Surgery, Emory University School of Medicine, Atlanta, Ga.
The Journal of thoracic and cardiovascular surgery
|August 19, 2023
概括
一种新的设备重塑左心室,并纠正心力衰竭患者的功能性 mitrale 吐. 这种方法减少了壁面的压力,改善了心脏功能,为心室扩张的人提供了新的希望.
科学领域:
- 心血管医学 心血管医学
- 生物医学工程 生物医学工程
- 干预心脏病学 干预心脏病学
背景情况:
- 晚期心力衰竭通常涉及扩张的左心室和功能性腹,治疗选择有限.
- 像MitraClip这样的现有设备在左心室较大的患者 (终端透气尺寸≥70毫米) 中显示出有限的益处.
- 扩大左心室壁压力的不足降低可能解释了现有治疗方法的有效性有限.
研究的目的:
- 评价一款设计用于重塑左心室和纠正功能性 mitrale regurgitation 的新型跳动心脏装置.
- 通过修改心室大小和形状来评估设备减少左心室壁应力的能力.
- 为了确定装置对中枢的几何和功能的影响.
主要方法:
- 这项研究使用了约克郡猪 (n=16) 诱导心肌梗塞和随后的心力衰竭和功能性腹.
- 在回声心脏学指导下,使用了跨吸管的方法来植入新型设备.
- 通过心声学和侵入性血液动力学评估对中枢和左心室的急性影响.
主要成果:
- 设备植入导致终端透析体积 (36.3±30.5毫升) 和球状度指数 (0.143±0.087) 显著下降.
- 喷射分数显著增加了5.90%±6.38%.
- mitra 门的几何状况得到改善,帐面积减少 (39.29 ± 33.66 mm2),并增加了合并长度 (2.12 ± 1.02 mm),从而减少了功能性 mitra 反.
结论:
- 拟议的设备有效地纠正功能性 mitrale 吐.
- 在两侧膜和左心室几何学上都取得了有利的变化.
- 这种新型设备展示了治疗晚期心力衰竭和左心室扩张的患者的潜力.
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