患有连续流动左心室辅助器件支持的患者中风的风险因素作为目的地治疗
Ioana B Florea1, Nadia H Bakir1, Meghan O Kelly1
1Department of Surgery, Division of Cardiothoracic Surgery, Washington University School of Medicine, Barnes-Jewish Hospital, St Louis, Missouri.
Texas Heart Institute journal
|August 6, 2025
概括
持续流动的左心室辅助器件 (LVAD) 越来越多地用于目的地治疗. 用HeartMate 3设备和阿米奥达龙与降低中风风险有关,而术后心房动增加了风险.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 医疗器械 医疗器械
背景情况:
- 连续流动的左心室辅助器件 (LVAD) 是日益增长的目标治疗选择.
- 在目的地治疗LVAD患者中,中风风险没有得到很好的描述.
- 这项研究评估了当代LVAD目的地治疗队列中的中风风险因素.
研究的目的:
- 为了描述接受连续流动LVAD治疗目的地治疗的患者中风的概况.
- 为了确定与此患者群体中风发作相关的风险因素.
主要方法:
- 对311名接受持续流动LVAD治疗目的地治疗的患者 (2010-2020年) 的回顾性分析.
- 脑卒中被定义为由于大脑血流中断导致的成像证实,持续的神经学缺陷.
- 竞争风险模型和细灰色回归用于评估结果和预测因素.
主要成果:
- 估计的中风发病率在5年后达到27%.
- 使用HeartMate 3设备 (HR 0.41) 和出院时的阿米奥达龙 (HR 0.55) 与较低的中风风险有关.
- 手术后心房动 (AF) 显著增加了中风风险 (HR 1.68).
结论:
- 与其他设备相比,HeartMate 3设备的中风率有所降低.
- 手术后的AF仍然是LVAD患者中风的重要危险因素.
- 在LVAD后对AF管理的保护策略和阿米奥达龙的进一步研究是有必要的.
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