在心力衰竭和没有心力衰竭的患者中,植入式心脏转换器-除器治疗的潜在益处
D Böcker1, D Bänsch, A Heinecke
1Hospital of the Westfälische Wilhelms-University of Münster, Departments of Cardiology, Germany.
Circulation
|October 20, 1998
概括
植入式心脏转换器-除器 (ICD) 对NYHA类I-III的心力衰竭患者有好处. 虽然初始益处在NYHA类II/III中最高,但NYHA类I的患者可能会从ICD治疗中获得最持久的生存优势.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 心脏衰竭管理的管理
背景情况:
- 植入式心脏变压器 (ICD) 在心力衰竭患者的疗效仍然是研究的主题.
- 评估纽约心脏协会 (NYHA) 功能类对ICD治疗益处的影响对于患者的选择和管理至关重要.
研究的目的:
- 调查NYHA功能类对ICD治疗带来的好处的影响.
- 分析ICD存储的电图数据,以评估患者的治疗结果.
主要方法:
- 在1989年至1996年期间,对603名接受ICD治疗的患者进行了回顾性分析.
- 植入时的NYHA功能类 (I-III) 与整体死亡率和心室动脉节律衰竭复发的相关性.
- 通过将观察到的死亡率与没有设备干预的假设死亡率进行比较,估计ICD的益处.
主要成果:
- 在所有研究的NYHA类别中,ICD植入证明了显著的生存益处.
- 随着时间的推移,NYHA I 类患者的估计效益增加 (15.2% 在 1 年,35.6% 在 5 年).
- 在NYHAII/III类的患者经历了实质性的好处,在3年后稳定 (大约3年). 这是一个非常重要的数字 (22-24%).
结论:
- ICD治疗与心力衰竭患者的延长存活率有关,这些患者在NYHA功能类I-III中有心室动脉冲动或动史.
- 最初的益处在NYHAII/III类患者中最大.
- 长期生存益处可能在NYHAI类患者中最为明显.
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