The Inflammatory Response to Ventricular Assist Devices.
The Inflammatory Response to Ventricular Assist Devices.
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DOI：
10.3389/fimmu.2018.02651
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发表时间：
2018
影响因子：
7.3
通讯作者：
Thornton CA
中科院分区：
文献类型：
--
作者：
Radley G;Pieper IL;Ali S;Bhatti F;Thornton CA
过去十年，心室辅助装置（VAD）对不适合移植的终末期心力衰竭（HF）患者的治疗使用量稳步增加。与此同时，VAD 设计的改进减少了设备尺寸、成本和设备相关的复杂性。这些并发症包括感染和血栓形成，它们都是炎症反应的基础贡献，并且仍然是 VAD 植入的常见风险。在设计支持心脏功能并帮助修复受损心肌的 VAD 时，另一个未被充分认识到的困难是不同类型的心力衰竭伴有不同的炎症特征，这些炎症特征可能会影响对植入装置的反应。循环炎症标志物和白细胞表型的变化作为死亡率和疾病进展的生物标志物受到广泛关注。然而，它们很少用于监测 VAD 治疗期间或新设备设计阶段的进展和结果。即使部分逆转与心力衰竭相关的心脏损伤也是使用 VAD 的理想结果。因此，更好地了解 VAD 与接受者炎症反应之间的相互作用将有可能增加其吸收，改善患者的生活，并推动与其他血液接触医疗设备相关的研究。在这里，我们回顾了目前对心力衰竭炎症的了解，以及接受 VAD 治疗的心力衰竭患者的炎症特征如何改变。
The therapeutic use of ventricular assist devices (VADs) for end-stage heart failure (HF) patients who are ineligible for transplant has increased steadily in the last decade. In parallel, improvements in VAD design have reduced device size, cost, and device-related complications. These complications include infection and thrombosis which share underpinning contribution from the inflammatory response and remain common risks from VAD implantation. An added and underappreciated difficulty in designing a VAD that supports heart function and aids the repair of damaged myocardium is that different types of HF are accompanied by different inflammatory profiles that can affect the response to the implanted device. Circulating inflammatory markers and changes in leukocyte phenotypes receive much attention as biomarkers for mortality and disease progression. However, they are seldom used to monitor progress during and outcomes from VAD therapy or during the design phase for new devices. Even the partial reversal of heart damage associated with heart failure is a desirable outcome from VAD use. Therefore, improved understanding of the interplay between VADs and the recipient's inflammatory response would potentially increase their uptake, improve patient lives, and fuel research related to other blood-contacting medical devices. Here we provide a review of what is currently known about inflammation in heart failure and how this inflammatory profile is altered in heart failure patients receiving VAD therapy.
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影响因子：
2.4
作者：
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