Implantation of ventricular assist devices in hypertrophic cardiomyopathy with left ventricular systolic dysfunction.
Implantation of ventricular assist devices in hypertrophic cardiomyopathy with left ventricular systolic dysfunction.
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DOI：
10.1002/ehf2.13653
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发表时间：
2021-12
影响因子：
3.8
通讯作者：
Fukushima N
中科院分区：
文献类型：
--
作者：
Yagi N;Seguchi O;Mochizuki H;Kuroda K;Nakajima S;Watanabe T;Yanase M;Tadokoro N;Fukushima S;Fujita T;Fukushima N
肥厚型心肌病伴左心室收缩功能障碍（HCM-LVSD）患者接受左心室辅助装置（LVAD）植入术的结局尚不清楚。我们回顾性评价了LVAD植入对HCM-LVSD患者临床结局的临床影响，包括与扩张型心肌病（DCM）患者相比的血流动力学和脑钠肽（BNP）水平。在这项在日本进行的回顾性、单中心、观察性研究中，审查了2011年至2020年期间在国家心脑血管中心接受LVAD植入术的患者的病历。我们招募了96名DCM患者（平均年龄：43.5岁; 73名男性）和24名HCM-LVSD患者（平均年龄：48.3岁; 16名男性）。与DCM组相比，HCM-LVSD组的左心室较小，心室壁较厚，在LVAD植入后变得更加突出。术前，两组的BNP值相当;然而，植入后3个月，HCM-LVSD组的BNP值显著较高。HCM-LVSD组的肺动脉搏动指数、右心室每搏作功指数和心脏指数较低，右心房压力较高，表明右心室功能亚临床损害。HCM-LVSD组表现出等同的结局，包括植入后的总生存期、脑血管意外、右心室衰竭、LVAD相关感染、心律失常和主动脉瓣关闭不全。尽管右心室功能下降且BNP值较高，但HCM-LVSD和DCM患者在LVAD植入后的结局相似。
The outcomes of patients with hypertrophic cardiomyopathy with left ventricular systolic dysfunction (HCM‐LVSD) undergoing left ventricular assist device (LVAD) implantation remain unclear. We retrospectively evaluated the clinical impact of LVAD implantation on clinical outcomes, including haemodynamics and brain natriuretic peptide (BNP) levels, in patients with HCM‐LVSD, in comparison with those with dilated cardiomyopathy (DCM). In this retrospective, single‐centre, observational study conducted in Japan, the medical records of patients who underwent LVAD implantation in the National Cerebral and Cardiovascular Center between 2011 and 2020 were reviewed. We enrolled 96 patients with DCM (average age: 43.5 years; 73 men) and 24 patients with HCM‐LVSD (average age: 48.3 years; 16 men). The HCM‐LVSD group had smaller left ventricles with thicker ventricular walls than the DCM group, which became more prominent after LVAD implantation. Preoperatively, BNP values were comparable between both groups; however, 3 months post‐implantation, they were significantly higher in the HCM‐LVSD group. Pulmonary artery pulsatility index, right ventricular stroke work index, and cardiac index were lower, and right atrial pressure was higher, in the HCM‐LVSD group, suggesting subclinical impairment of right ventricular function. The HCM‐LVSD group demonstrated equivalent outcomes, including overall survival, cerebrovascular accidents, right ventricular failure, LVAD‐related infections, arrhythmia, and aortic insufficiency, post‐implantation. Despite a decreased right ventricular function with higher BNP values, patients with HCM‐LVSD and DCM showed comparable outcomes post‐LVAD implantation.
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影响因子：
39.3
作者：
Elliott, Perry M.;Anastasakis, Aris;Watkins, Hugh
通讯作者：
Watkins, Hugh
影响因子：
4.8
作者：
Roldan, Vanessa;Marin, Francisco;Vicente, Vicente
通讯作者：
Vicente, Vicente
影响因子：
37.8
作者：
Harris, Kevin M.;Spirito, Paolo;Maron, Barry J.
通讯作者：
Maron, Barry J.
影响因子：
2.4
作者：
Hellman, Yaron;Malik, Adnan S.;Hadi, Azam
通讯作者：
Hadi, Azam
影响因子：
8.9
作者：
Hebl, Virginia B.;Miranda, William R.;Geske, Jeffrey B.
通讯作者：
Geske, Jeffrey B.