晚期心力衰竭患者的血管功能和持续流动或脉动性心室辅助设备
Valentina A Rossi1, Delia Nebunu2, Matthias P Nägele3
1Department of Cardiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland. Valentina.rossi@usz.ch.
概括
心室辅助器件 (VADs) 在晚期心力衰竭患者中改善大动脉内皮功能. 然而,在VAD植入后,微血管功能保持不变,这表明对宏血管健康的特定益处.
科学领域:
- 心血管医学 心血管医学
- 血管生物学 血管生物学
- 心脏衰竭研究研究
背景情况:
- 晚期心力衰竭 (HF) 显著增加了发病率和死亡率.
- 机械循环支持与心室辅助器件 (VADs) 是符合条件的患者的选择.
- 血管功能障碍是HF病理生理学的核心,但VAD的影响尚不清楚.
研究的目的:
- 调查VAD植入物对晚期心力衰竭中内皮血管功能的影响.
- 为了比较VAD接受者和倾向匹配的高级HF患者之间的宏血管和微血管功能.
主要方法:
- 通过大动脉的流量介导血管扩张 (FMD) 和微循环的闪光诱导视网膜血管扩张 (FID) 评估内皮功能.
- 将34名VAD患者 (26名CF-LVAD,8名bi-VAD) 与34名倾向匹配的高级HF患者进行了比较.
- 评估动脉静脉比率 (AVR) 作为视网膜血管度的指标.
主要成果:
- 与先进的高血压患者相比,VAD患者的口病明显改善 (7.2%对5.0%,p=0.03).
- 两组之间没有观察到微血管功能 (FIDart) 的显著差异 (p=0.78).
- 接受VAD的患者的AVR较高 (0.90对0.85,p=0.01),表明视网膜血管直径发生变化.
结论:
- VAD植入改善了高级HF患者大动脉中的内皮功能.
- 微血管功能不受VAD支持的显著影响.
- 在连续流动LVAD和脉动性双VAD之间没有发现血管功能的差异.
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