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左心室辅助装置植入后的早期中风:右心力衰竭的作用

Ilkun Park¹, Jeong Hoon Yang², Darae Kim²

¹Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Journal of thoracic disease

|January 22, 2024

概括

在左心室辅助装置 (LVAD) 植入后的右心力衰竭 (RHF) 是早期中风的重要危险因素. 管理RHF并保持足够的脑 perfusion 压力 (CPP) 可能有助于预防LVAD后的中风.

科学领域:

心脏病学心脏病学
神经学神经学
医疗器械医疗器械

背景情况:

左心室辅助装置 (LVAD) 植入与严重的并发症有关,包括中风和右心力衰竭 (RHF).
了解LVAD后早期中风和RHF之间的关系对于患者管理至关重要.

研究的目的:

为了研究中风和右心力衰竭 (RHF) 发生在左心室辅助器件 (LVAD) 植入后的早期之间.
在接受LVAD植入的患者中确定早期中风的预测因素.

主要方法:

在2012年至2020年期间接受LVAD植入的70名患者的回顾性观察队列研究.
早期中风定义为植入后6个月内发生的;使用INTERMACS标准诊断的RHF.
考克斯多变量分析和ROC分析被用来确定早期中风的预测因素.

主要成果:

14名患者 (20%) 经历了早期中风. 手术后的RHF在中风患者中明显更常见 (64.3%与23.2%,P=0.008).
手术后的RHF (HR:5.063) 和手术后第一天的脑 perfusion 压力 (CPP) (HR:0.923) 是早期中风的独立预测因素.
62mmHg的CPP切线预测了早期中风,敏感度为71.4%,特异性为59.3%.

结论:

在LVAD植入后的右心力衰竭 (RHF) 可能成为早期中风的危险因素.
有效预防和管理手术后的RHF,以及维持足够的CPP,对于减少LVAD植入后早期中风的发生率至关重要.

关键词:

左心室辅助器件 (LVAD) 是指一个左心室辅助器件.早期的中风中风早期的中风机械循环支持机械循环支持术后中风术后中风术后中风右心力衰竭 (RHF) 是一种疾病.

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