Mode-of-action of the PROPELLA concept in fulminant myocarditis
Mode-of-action of the PROPELLA concept in fulminant myocarditis
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PROPELLA概念在暴发性心肌炎中的作用方式
DOI：
10.1093/eurheartj/ehz124
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发表时间：
2019-07-07
影响因子：
39.3
通讯作者：
Tschoepe, Carsten
中科院分区：
文献类型：
--
作者：
Spillmann, Frank;Van Linthout, Sophie;Tschoepe, Carsten
血流动力学负荷通过机械传导途径诱导心脏重塑，进而引发炎症反应。我们假设，特别是在炎症性疾病，如心肌炎，治疗策略是必需的，除了提供足够的循环支持，卸载左心室，降低心壁应力，减轻inflammatory responses.Methods和结果轴流泵，如Impella系统符合这些要求。在这里，我们报告了一个潜在的长期Impella支持的行动模式（PROPELLA概念）治疗暴发性心肌炎，包括心脏免疫细胞存在减少，以及卸载期间整合素α 1、α 5、α 6、α 10和β 6表达减少。结论PROPELLA可能提供超出其机械循环支持主要功能的益处，其形式为额外的改变疾病的作用，这可能有助于增强慢性暴发性心肌炎患者的心肌恢复/缓解。
Aims Haemodynamic load induces cardiac remodelling via mechano-transduction pathways, which can further trigger inflammatory responses. We hypothesized that particularly in an inflammatory disorder such as myocarditis, a therapeutic strategy is required which, in addition to providing adequate circulatory support, unloads the left ventricle, decreases cardiac wall stress, and mitigates inflammatory responses.Methods and results Axial flow pumps such as the Impella systems comply with these requirements. Here, we report a potential mode-of-action of prolonged Impella support (PROPELLA concept) in fulminant myocarditis, including a decrease in cardiac immune cell presence, and integrin alpha 1, alpha 5, alpha 6, alpha 10 and beta 6 expression during unloading.Conclusion PROPELLA may provide benefits beyond its primary function of mechanical circulatory support in the form of additional disease-altering effects, which may contribute to enhanced myocardial recovery/remission in patients with chronic fulminant myocarditis.