Cardiac fibrosis and cellular hypertrophy decrease the degree of reverse remodeling and improvement in cardiac function during left ventricular assist
Cardiac fibrosis and cellular hypertrophy decrease the degree of reverse remodeling and improvement in cardiac function during left ventricular assist
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DOI：
10.1016/j.healun.2010.01.007
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发表时间：
2010-06-01
影响因子：
8.9
通讯作者：
Sawa, Yoshiki
中科院分区：
文献类型：
--
作者：
Saito, Shunsuke;Matsumiya, Goro;Sawa, Yoshiki
背景技术背景：本研究探讨了左心室辅助装置（LVAD）植入时心脏纤维化程度和心肌细胞大小是否可预测LVAD植入后心功能改善和持续恢复的程度。在LVAD植入前和LVAD关闭试验期间测量左心室舒张末期（LVEDD）和收缩末期直径（LVESD）、左心室射血分数（LVEF）、平均肺动脉压（mPAP）、肺毛细血管楔压（PCWP）和心脏指数（Cl）。在LVAD植入时从心尖核心获得心肌组织。心肌纤维化程度与LVEDD的变化有显著相关性（r =-0.725，p < 0.0001），LVESD（r =-0.800，p < 0.0001）、LVEF（r =-0.637，p < 0.0001）、mPAP（r =-0.569，p = 0.0010）、PCWP（r =-0.463，p = 0.0123）和Cl（r =-0.544，p = 0.0015）。心肌细胞大小也与LVEDD（r =-0.386，p = 0.0235）、LVESD（r =-0.414，p = 0.0141）和LVEF（r =-0.528，p = 0.0015）的变化显著相关。9例患者成功取出LVAD。在这些患者的心脏纤维化和心肌细胞大小的程度是显着较小的患者相比，谁没有接受LVAD remove.CONCLUSIONS：心脏纤维化和心肌细胞大小在LVAD植入的时间是显着的预测心脏功能的改善程度和持续恢复LVAD removation后。J Heart Lung Transplant 2010;29：672-79（C）2010年国际心肺移植学会。All rights reserved.
BACKGROUND: This study investigated if the degree of cardiac fibrosis and myocyte size at the time of left ventricular assist device (LVAD) implantation predicts the degree of improvement in cardiac function and sustained recovery after LVAD explantation.METHODS: The study included 34 patients who underwent LVAD-off test. LV end-diastolic (LVEDD) and end-systolic diameter (LVESD), LV ejection fraction (LVEF), mean pulmonary artery pressure (mPAP), pulmonary capillary wedge pressure (PCWP), and cardiac index (Cl) were measured before LVAD implantation and during LVAD-off test. Myocardial tissue was obtained from the apical core at LVAD implantation.RESULTS: The degree of cardiac fibrosis had significant correlations with changes in LVEDD (r = -0.725, p < 0.0001), LVESD (r = -0.800, p < 0.0001), LVEF (r = -0.637, p < 0.0001), mPAP (r = -0.569, p = 0.0010), PCWP (r = -0.463, p = 0.0123), and Cl (r = -0.544, p = 0.0015). Myocyte size also had significant correlations with changes in LVEDD (r = -0.386, p = 0.0235), LVESD (r = -0.414, p = 0.0141), and LVEF (r = -0.528,p = 0.0015). The LVAD was successfully removed in 9 patients. The degree of cardiac fibrosis and myocyte size in these patients was significantly smaller compared with the patients who did not undergo LVAD removal.CONCLUSIONS: Cardiac fibrosis and myocyte size at the time of LVAD implantation were significant predictors of degree of improvement of cardiac function and the sustained recovery after the LVAD explantation. J Heart Lung Transplant 2010;29:672-79 (C) 2010 International Society for Heart and Lung Transplantation. All rights reserved.