轴心机械循环支持在慢性病患者心脏移植前改善功能
Ji-Min Jang1, Tambi Jarmi2, Basar Sareyyupoglu3
1Division of Heart Failure and Transplant, Mayo Clinic Florida, 4500 San Pablo Road, Jacksonville, FL, 32246, USA.
Scientific reports
|November 11, 2023
概括
使用Impella 5.5的临时机械循环支持 (tMCS) 在晚期心力衰竭患者中改善了功能,避免了替代疗法或结合心移植的需要.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 医疗器械 医疗器械
背景情况:
- 功能障碍复杂化了先进的心力衰竭,恶化了预后.
- 现有的数据显示,在持久的LVAD安置期间,急性损伤与慢性病的结果更差.
- 结合心脏移植的存活率比单独心脏移植的存活率要低.
研究的目的:
- 为了评估等待移植的心力衰竭患者的功能恢复,在Impella 5.5.5.的临时机械循环支持 (tMCS) 的支持下.
- 评估tMCS对高风险人群中血液动力学和功能参数的影响.
- 确定tMCS是否可以防止需要脏替代疗法或双器官移植.
主要方法:
- 在2020年1月至2021年2月期间,对患有急性或慢性心力衰竭和脏疾病的患者进行过tMCS (Impella 5.5) 的回顾性评估.
- 在tMCS安置和移植之前和之后,对血液动力学和功能趋势 (肌素,GFR) 的分析.
- 收集的数据包括tMCS前后的肌素,估计的GFR,血红素和出院结果.
主要成果:
- tMCS安置显示了改善肌素,心脏指数,静脉和GFR的趋势.
- 中位数GFR从tMCS前的34mL/min/BSA提高到tMCS后的44mL/min/BSA,并在释放时进一步提高到72.
- 血清肌氨酸的中位数从tMCS前的2.1 mg/dL提高到tMCS后的1.5 mg/dL和出院时的1.1 mg/dL.
- 六名患者中,没有一个在心脏移植后需要脏替代疗法.
结论:
- 早期采用Impella 5.5作为tMCS在患有晚期心力衰竭和脏疾病的患者中可以导致显著的恢复.
- 这种方法可以避免需要脏替代疗法或联合心脏脏移植.
- 在这种患者群体中,需要进一步评估使用Impella 5.5的tMCS.
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