肥胖,挑战和减肥策略对于患有心室辅助器件的患者
Adrian daSilva-deAbreu1, Jo E Rodgers2, Jessica Seltz3
1Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA; Doctoral School, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.
JACC. Heart failure
|June 21, 2024
概括
肥胖对晚期心力衰竭患者构成挑战,往往阻止心脏移植 (HT). 腹腔外科手术有助于LVAD患者寻求HT的减肥,但需要仔细考虑.
科学领域:
- 心脏病学 心脏病学
- 腹部外科 腹部外科
- 移植医学 移植医学
背景情况:
- 二/三级肥胖 (BMI ≥35 kg/m2) 对患有晚期心力衰竭的成年人构成重大挑战.
- 在许多医疗中心,肥胖是心脏移植 (HT) 的禁忌.
- 体重管理对于晚期心力衰竭患者成为HT候选人至关重要.
研究的目的:
- 审查肥胖和减肥策略对左心室辅助器件 (LVAD) 患者的影响.
- 评估减肥手术 (BSx) 的有效性,使LVAD患者能够获得足够的体重减轻,以获得HT候选.
- 讨论接受BSx的LVAD接收者进行外科手术期间的考虑.
主要方法:
- 对公布的关于LVAD患者肥胖和减肥干预措施的报告进行系统审查.
- 在心脏移植候选人背景下分析腹部外科手术结果.
- 对接受BSx.LVAD患者的术后治疗方案的数据的解释.
主要成果:
- 减肥手术在减肥策略中显示出最高的有效性,可显著减肥.
- BSx使得一些肥胖的LVAD患者有资格接受HT.
- 无论是BSx还是抗肥胖药物,都需要在LVAD人群中谨慎使用.
结论:
- 减肥策略,特别是减肥手术,对于改善肥胖高级心力衰竭患者的HT候选人来说至关重要.
- 对于接受减肥手术的LVAD接受者来说,精心的术后管理是必不可少的.
- 需要进一步的研究,以优化使用减肥干预措施在这个患者队列.
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