心力衰竭患者降低射出分数的巴罗反射激活疗法:单中心体验
Carola Blanco1, Tomas Madej2, Norman Mangner1
1Department of Internal Medicine and Cardiology, Heart Centre Dresden, University Hospital, Technische Universität Dresden, Dresden, Germany.
ESC heart failure
|September 4, 2023
概括
使用Barostim NeoTM设备的巴罗反射激活疗法 (BAT) 对心力衰竭和减少排气率 (HFrEF) 患者是安全的,改善症状并适度增强左心室功能. 然而,晚期的死亡风险仍然很高,这强调了需要仔细选择患者的必要性.
科学领域:
- 心脏病学 心脏病学
- 生物医学工程 生物医学工程
- 自主神经系统研究 自主神经系统研究
背景情况:
- 减少喷射分数 (HFrEF) 的心力衰竭涉及自主神经系统失衡.
- 巴罗斯蒂姆NeoTM设备提供巴罗反射激活疗法 (BAT) 来解决这种不平衡.
- 之前的试验表明,在中度的HFrEF中,BAT提高了运动能力和NT-proBNP.
研究的目的:
- 评估在现实环境中对高级HFrEF患者的BAT临床结果.
- 评估 BAT 关于心力衰竭住院和死亡率的安全性和有效性.
- 为了确定接受BAT的HFrEF患者死亡率的预测因素.
主要方法:
- 以BAT治疗的30名HFrEF患者 (NYHA III/IV类,LVEF <35%) 的回顾性,单中心注册.
- 评估症状负担,心声回声和实验室标记在基线和12个月.
- 在例行随访期间记录临床事件 (HFH,死亡).
主要成果:
- 在所有患者中,BAT植入成功.
- 在12个月后,NYHA类有所改善 (P < 0.001),LVEF增加 (25.5%至30.0%,P = 0.014).
- 一年和三年死亡率分别为20%和33%,与风险得分保持一致. 预测死亡率的NYHA类和eGFR.
结论:
- 最佳技术是安全的,并改善症状和左心室功能在先进的HFrEF.
- 高死亡风险在晚期疾病阶段仍然存在.
- 关键的患者选择是必要的;在早期HFrEF阶段对BAT进行进一步的研究是有必要的.
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