智利PLASMA:对心力衰竭和左心室喷射分数减少的患者进行前性多中心观察队列研究
Rubén Aguayo1, Fernando Lanas2, Hugo Verdejo3
1Servicio de Cardiología y Arritmias, Hospital San Juan de Dios, Santiago, RM, Chile.
Heart rhythm O2
|January 16, 2026
概括
在智利,心力衰竭 (HF) 患者接受标准药物治疗,但面临心脏植入式电子设备 (CIED) 的障碍. 尽管有指导方针建议使用这些设备,但这些设备仍未得到充分使用,这影响了患者的治疗结果.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 公共卫生 公共卫生
背景情况:
- 关于智利心力衰竭 (HF) 治疗的数据有限,特别是对于左心室喷射分数 (LVEF) 减少的患者.
- 了解遵守国际指导方针和设备使用情况对于改善患者护理至关重要.
研究的目的:
- 评估遵守2017年AHA/ACC/HRS指南对高频管理的建议.
- 确定心脏植入式电子设备 (CIED) 在患有高血压和减少LVEF的患者中使用的障碍.
- 评估CIED植入和这一群体的死亡率之间的关联.
主要方法:
- 从2021年3月到2022年12月,在智利的6家医院进行了一项前性的多中心观察队列研究.
- 成年患者 (≥18岁) 患有HF和LVEF≤40%被纳入,收集了社会人口统计学,临床和治疗数据.
- 为了评估结果,进行了描述性统计和Cox无变量回归分析.
主要成果:
- 该研究包括243名患有HF的患者;34.4%的符合条件的患者有基线CIED,可植入式心脏转换器-除器 (ICD) 和心脏再同步治疗除器 (CRT-Ds) 等推设备的使用量明显不足.
- 在随访期间,75名符合条件的患者中,只有27名患者接受了推的ICD或CRT-D,38名患者面临访问问题作为障碍.
- 尽管有指导方针建议,但在服用CIED和不服用CIED的患者之间没有观察到显著的死亡率差异.
结论:
- 在智利,患有HF和减少LVEF的患者接受了符合指南的药理疗法.
- 显著的接入障碍限制了CIED的利用,尽管其已证明的好处,但CIED仍未得到充分利用.
- 需要进一步的研究来解决这些障碍,并优化CIED植入率,以改善HF管理.
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