通过入侵式斜坡测试对患者进行血动力学优化,这些患者得到了HeartMate 3左心室辅助装置的支持
Gal Rubinstein1, Cathrine M Moeller1, Dor Lotan1
1From the Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, New York.
ASAIO journal (American Society for Artificial Internal Organs : 1992)
|February 19, 2024
概括
在稳定的患者中,优化HeartMate 3左心室辅助装置 (LVAD) 速度可以改善血液动力学. 压力优化与再入院减少相关,主要是与心脏相关的住院治疗.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 血液动力学 血液动力学
背景情况:
- 心脏Mate 3左心室辅助装置 (HM3 LVAD) 的速度调整可以优化患者的血液动力学.
- 评估速度调整的血液动力学影响对于患者管理至关重要.
研究的目的:
- 为了研究HM3 LVAD接收器在机场测试期间调节速度的血液动力学效应.
- 为了确定优化填充压力 (CVP <12 mmHg,PCWP <18 mmHg) 是否会影响再接收率.
主要方法:
- 对60名稳定的HM3 LVAD接受者进行了回顾性分析,这些接受者接受了常规的侵入性血液动力学斜坡测试 (2015-2022年).
- 在基线和最终速度时评估填充压力.
- 优化和非优化填充压力的患者之间的结果比较.
主要成果:
- 58%的患者在基线速度时实现了最佳的填充压力.
- 84%的非优化患者进行了速调整,最终速度的优化达到65%.
- 优化填充压力与更高的6个月和12个月无再入院率相关 (p=0.03),主要是由于心脏再入院较少 (p=0.052).
结论:
- 只有三分之二的稳定的HM3 LVAD门诊患者在例行台测试中实现了优化血液动力学.
- 达到最佳填充压力与更好的临床结果有关,特别是减少全因和心脏再入院.
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