在目的地治疗中心植入高风险的左心室辅助装置后,功能类的趋势和预测因素
相关实验视频
Updated: Jun 9, 2025
16:11
Implantation of the Syncardia Total Artificial Heart
Published on: July 18, 2014
35.2K
John B Eisenga1,2,3, Kyle A McCullough1,2, Aasim Afzal4
1Department of Cardiac Surgery, Baylor Scott and White, The Heart Hospital, Plano, TX, USA.
Journal of thoracic disease
|October 24, 2024
概括
左心室辅助装置 (LVAD) 植入显著改善了高风险患者的功能类. 缺血性心力衰竭的病因是LVAD手术后持续功能改善的最强有力的预测因素.
科学领域:
- 心脏病学 心脏病学
- 心血管外科心血管外科
- 医疗器械 医疗器械
背景情况:
- 左心室辅助装置 (LVAD) 植入改善了生存率,但高风险患者的长期功能类影响不太了解.
- 目的地治疗 (DT) LVADs越来越多地用于晚期心力衰竭.
- 评估LVAD后的功能状态对于治疗疗效评估至关重要.
研究的目的:
- 评估目标治疗 (DT) 植入LVAD对患者功能类的长期影响.
- 在接受LVADs的患者中确定可持续功能改善的预测因素.
- 了解高风险LVAD队列中的功能结果.
主要方法:
- 在一个中心 (2017-2023) 进行151次初级LVAD植入的回顾性审查.
- 主要结局:纽约心脏协会 (NYHA) 的功能类评估.
- 多变量后勤回归以确定持续功能改善的预测因素 (活在1年内与NYHA类I或II).
主要成果:
- 术后死亡率为7.95%.
- 在6个月后,92.62%的患者改善了功能类;在12个月后,91.49%的患者持续改善.
- 心力衰竭 (HF) 的缺血病因是持续功能改善的重要预测因素 (OR:5.53,P=0.04).
结论:
- 在NYHA类中,LVAD植入导致显著和持续的功能改善,即使是在高风险患者中.
- 缺血性心力衰竭的病因是LVAD后实现和维持改善功能状态的最重要的预测因素.
- LVADs代表了改善晚期心力衰竭患者的生活质量的可行选择.
相关概念视频
01:30Heart Failure IV: Classification and Diagnostic Evaluation
1
Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
1
01:29Cardiomyopathy V: Interprofessional Care
1
Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
1
01:30Cardiomyopathy II: Dilated Cardiomyopathy
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
01:17Pathophysiology of Heart Failure
1.5K
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...
1.5K
01:22Heart Failure VI: Adjunct Therapies
1
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
1