HF病因学和心脏收缩性调制疗法
Karapet Davtyan1, Ivan Chugunov1, Arpi Topchyan2
1National Medical Research Center for Therapy and Preventive Medicine, Moscow, Russia.
BMC cardiovascular disorders
|May 29, 2024
概括
心脏收缩性调制 (CCM) 疗法改善了心脏功能,在心力衰竭患者心脏衰竭与减少喷射率 (HFrEF). 非缺血性HFrEF患者的左心室喷射率 (LVEF) 比缺血性患者有更大的改善,存活率相似.
科学领域:
- 心脏病学 心脏病学
- 心脏衰竭研究研究
- 医疗器械技术 医疗器械技术
背景情况:
- 减少喷射分数 (HFrEF) 的心力衰竭仍然是一个重大的临床挑战,需要先进的治疗策略.
- 心脏收缩性调制 (CCM) 疗法为对最佳医疗治疗耐药的HFrEF患者提供了潜在的治疗选择.
研究的目的:
- 评估CCM治疗在HFrEF患者的安全性和有效性,根据心力衰竭 (HF) 的病因分层.
- 为了比较经过CCM治疗的缺血性 (ICM) 和非缺血性 (NICM) HFrEF患者之间的治疗结果.
主要方法:
- 对166名耐药HFrEF患者的回顾性分析,这些患者在2013年至2019年期间接受了CCM设备植入.
- HF病因通过冠状动脉血管学或心脏MRI确定. 包括左心室喷射分数 (LVEF),6分钟步行测试 (6MWT) 和NYHA类在基线和植入后12个月评估的结果.
主要成果:
- 在ICM (61.5%) 和NICM (38.5%) 组之间没有观察到死亡率的显著差异.
- 与12个月的ICM患者相比,接受NICM的患者在LVEF (7.7%对2.0%,p<0.001) 和LV逆转改造方面表现出显著更大的改善.
- 6MWT和NYHA类的改善在两组之间没有显著差异,尽管心房动和COPD等因素与较差的NYHA类改善有关.
结论:
- CCM疗法是药物耐药HFrEF的可行选择,根据HF病因学,生存率没有显著差异.
- 与缺血性HFrEF患者相比,在CCM植入后,非缺血性HFrEF患者在LVEF和LV逆重塑方面经历了优异的改善.
更多相关视频
12:45Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
Published on: December 11, 2017
10.5K
09:20Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
Published on: February 13, 2021
6.4K
相关概念视频
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
421
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
421
01:17Pathophysiology of Heart Failure
1.6K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
1.6K
01:26Heart Failure Drugs: Inotropic Agents
570
Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
570
01:22Heart Failure Drugs: β-Blockers
336
β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
336
01:29Pathophysiology of Cardiac Performance
635
Typical heart performance is influenced by heart rate, rhythm, myocardial contraction, and metabolism or blood flow. The cardiac muscle exhibits distinct electrophysiological features, including pacemaker activity and calcium channel control, which play a vital role in the heart's response to various drugs. The autonomic nervous system, comprising the sympathetic and parasympathetic branches, regulates heart rate. Sympathetic activation increases heart rate, while parasympathetic activation...
635
01:22Heart Failure Drugs: Diuretics
363
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
363