Contrast-Enhanced Ultrasound of Muscle Perfusion May Indicate Patient Response to Left Ventricular Assist Device Therapy.
Contrast-Enhanced Ultrasound of Muscle Perfusion May Indicate Patient Response to Left Ventricular Assist Device Therapy.
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DOI：
10.1002/jum.15658
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发表时间：
2021-12
影响因子：
2.3
通讯作者：
Reeves, Gordon R.
中科院分区：
文献类型：
--
作者：
Delaney, Lauren J.;Fitzgerald, Kathleen;Stanczak, Maria;Machado, Priscilla;Entwistle, John W. C.;Forsberg, Flemming;Reeves, Gordon R.
左心室辅助装置（LVAD）支持与外周血管异常相关，而不是与心力衰竭（HF）相关。这些异常与对生活质量（QoL）产生不利影响的持续性功能障碍相关。需要测量该人群外周血管功能的方法。本初步研究采用标准化方案研究了超声造影（CEUS）的使用，以估计接受LVAD植入术的HF患者（INTERMACS profile 3）（n = 7）外周（四头肌）肌肉灌注的变化。然后，患者按照报告LVAD支持后QoL改善的患者（"应答者"，n = 4）和未报告QoL改善的患者（"无应答者"，n = 3）进行分层。术前和LVAD植入后3个月的系列测量结果显示，所有基于CEUS的测量结果在静息或运动刺激时对整个人群的肌肉灌注无显著变化（P> 0.23）。与基线相比，3个月时应答者静息时肌肉灌注改善（P = 0.043），达到峰值对比增强的时间缩短（P = 0.010），表明LVAD后肢体血液输送改善。LVAD治疗后，无应答者显示静息肌肉灌注（P> 0.99）、达到峰值对比增强的时间（P = 0.59）和对运动刺激的反应（P> 0.99）无变化。我们的研究结果表明，CEUS评价是一种有前途的非侵入性，定量的方式，实时评估外周血管和肌肉灌注作为LVAD受体的治疗反应的指示，这种方式可以捕获灌注措施重要的生活质量LVAD植入后。
Left ventricular assist device (LVAD) support is associated with peripheral vascular abnormalities beyond those associated with heart failure (HF). These abnormalities are associated with persistent functional impairments that adversely impact quality of life (QoL). Methods for measuring peripheral vascular function in this population are needed. This pilot study investigated the use of contrast-enhanced ultrasound (CEUS) using standardized protocols to estimate changes in peripheral (quadriceps) muscle perfusion among patients with HF (INTERMACS profile 3) undergoing LVAD implantation (n = 7). Patients were then stratified by those who did (“responders”, n = 4) and did not (“nonresponders”, n = 3) report QoL improvement with LVAD support. Serial measurements obtained preoperatively and 3 months following LVAD implantation showed no significant change (P > .23) in muscle perfusion by all CEUS-based measures at rest or with an exercise stimulus for the overall population. Responders exhibited improved muscle perfusion at rest (P = .043) and decreased time to peak contrast enhancement (P = .010) at 3 months compared with baseline, suggesting improved delivery of blood to the extremities post-LVAD. Nonresponders showed unchanged resting muscle perfusion (P > .99), time to peak contrast enhancement (P = .59), and response to exercise stimulus (P > .99) following LVAD therapy. Our findings suggest that CEUS evaluation is a promising noninvasive, quantitative modality for real-time assessment of peripheral vasculature and muscle perfusion as an indication of treatment response in LVAD recipients and that this modality may capture perfusion measures important to QoL following LVAD implantation.
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影响因子：
8.9
作者：
Loyaga-Rendon, Renzo Y.;Plaisance, Eric P.;Shah, Keyur
通讯作者：
Shah, Keyur
影响因子：
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作者：
Baumwol, Jay;Macdonald, Peter S.;Hayward, Christopher S.
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影响因子：
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作者：
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DOI：
10.1080/08998280.2019.1576095
发表时间：
2019-04-01
期刊：
Proceedings (Baylor University. Medical Center)
影响因子：
--
作者：
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通讯作者：
Hall, Shelley A
影响因子：
6
作者：
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