Changes in the Functional Status Measures of Heart Failure Patients With Mechanical Assist Devices
Changes in the Functional Status Measures of Heart Failure Patients With Mechanical Assist Devices
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DOI：
10.1097/mat.0b013e3182816cb7
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发表时间：
2013-03-01
期刊：
影响因子：
4.2
通讯作者：
Pae, Walter E.
中科院分区：
文献类型：
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作者：
Leibner, Evan S.;Cysyk, Joshua;Pae, Walter E.
已证明连续流左心室辅助装置（cfLVAD）对于晚期心力衰竭患者的移植桥和目的地治疗（DT）是安全有效的。然而，这些装置的固定泵速可能缺乏对活动和氧气需求的响应，从而限制了运动耐力。这项观察性研究的目的是描述通过在cfLVAD支持期间预期的峰值耗氧量（峰值VO 2）测量的运动能力。测量患者的峰值VO 2（平均年龄：58.3 ± 11.7岁; cfLVAD支持前66.7%缺血和33.3% DT）（11.2 +/- 3.0 ml/kg/min，n = 25），3 - 6个月（12.7 +/- 3.5 ml/kg/min，n = 31）、1年时（10.7 +/- 2.6 ml/kg/min，n = 16）和超过1年时（11.2 +/- 1.7 ml/kg/min，n = 10）。在植入后的任何时间点，峰值VO 2均无统计学改善。此外，LVAD植入后在所有时间点的清除效率仍然很差。尽管研究表明生存率和患者生活质量有所提高，但在cfLVAD支持期间，通过心肺运动试验测量的运动能力仍然较低。ASAIO Journal 2013;59：117-122.
Continuous-flow left ventricular assist devices (cfLVADs) have been proven safe and effective for bridge-to-transplant and destination therapy (DT) in patients with advanced heart failure. However, the fixed pump speed of these devices may lack response to activity and oxygen demand, thereby limiting exercise tolerance. The objective of this observational study was to describe exercise capacity as measured by peak oxygen consumption (peak VO2) that may be expected during support with a cfLVAD. Peak VO2 was measured in patients (mean age: 58.3 +/- 11.7 years; 66.7% ischemic and 33.3% DT) before cfLVAD support (11.2 +/- 3.0 ml/kg/min, n = 25), between 3 and 6 months (12.7 +/- 3.5 ml/kg/min, n = 31), at 1 year (10.7 +/- 2.6 ml/kg/min, n = 16), and longer than 1 year (11.2 +/- 1.7 ml/kg/min, n = 10). There was no statistical improvement in peak VO2 at any time point after implantation. In addition, ventilatory efficiency remained poor after LVAD implantation at all time points. Although studies have shown an increase in survival and patient's quality of life, exercise capacity as measured by cardiopulmonary exercise testing remains low during cfLVAD support. ASAIO Journal 2013;59:117-122.