重血管化和左心室功能障碍对于ICD的资格
Letizia Rosa Romano1, Carmen Anna Maria Spaccarotella2, Ciro Indolfi1
1Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, 88100 Catanzaro, Italy.
Life (Basel, Switzerland)
|September 28, 2023
概括
突然心脏死亡 (SCD) 经常与缺血性心脏病有关. 重血管和植入式心脏转换器-除器 (ICD) 可以预防SCD,但最佳时间仍在争论中.
科学领域:
- 心脏病学 心脏病学
- 电力生理学 电力生理学
- 心血管外科心血管外科
背景情况:
- 心脏突然死亡 (SCD) 是一种快速节律障碍,通常发生在患有缺血性心脏病和左心室功能障碍 (LVD) 的患者中.
- 重血管化可以预防SCD和心力衰竭 (HF) 等不良结果,而植入式心脏转换器-除器 (ICD) 在管理心室动脉冲动 (VT) 和心室动 (VF) 上是有效的.
研究的目的:
- 审查重血管化的病理生理学益处,以预防SCD.
- 分析与ICD植入一起进行皮肤,手术或没有再血管化的研究.
- 讨论对于过渡性SCD风险或高风险ICD候选人的新兴除策略.
主要方法:
- 关于突发心脏病死亡风险患者的重血管化策略 (透皮,手术) 和ICD植入等研究的文献综述.
- 分析重血管化时间对左心室重塑和ICD手术潜在并发症的影响.
- 对特定患者群体的新兴除技术的检查.
主要成果:
- 重新血管化显著影响 LV 重塑,并可以防止 SCD 和 HF.
- 对LVD患者来说,ICD优于抗不律性药物,具有VT/VF,并具有已证明的初级预防益处.
- 与再血管化相比,ICD植入的最佳时间被争论,同时考虑抗血小板治疗和手术风险.
结论:
- 重血管为患有缺血性心脏病和LVD的患者提供了显著的好处,降低了SCD风险.
- ICD植入是预防高风险个体SCD的关键干预措施.
- 需要进行进一步的研究,以确定重新血管化和ICD植入的时间管理的最终指南.
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