Left ventricular remodeling and myocardial recovery on mechanical circulatory support.
Left ventricular remodeling and myocardial recovery on mechanical circulatory support.
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DOI：
10.1016/j.cardfail.2009.10.018
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发表时间：
2010-02
影响因子：
6
通讯作者：
McNamara, Dennis M.
中科院分区：
文献类型：
--
作者：
Simon, Marc A.;Primack, Brian A.;Teuteberg, Jeffrey;Kormos, Robert L.;Bermudez, Christian;Toyoda, Yoshiya;Shah, Hemal;Gorcsan, John, III;McNamara, Dennis M.
VAD后心肌恢复很少见，但在非缺血性心肌病(NICM)中更为常见。我们试图评估左心室(LV)的舒张末内径(LVEDD)来预测VAD后的恢复情况。回顾1996-2008年接受长期机械支持的NICM患者。受试者分为3组：轻度扩张组22例，中度扩张组22例，重度扩张组32例，分别为6.0~7.0 cm组和7.0 cm组(48例)。总体而言，102名受试者中有14人(14%)恢复了(成功的外植体而不是移植)。其中2人死亡，2人在一年内需要移植。无左室扩张者(A/B/C=32%/22%/0%，P<；0.001)和持续性恢复(移植后1年存活且无移植；A/B/C=27%/10%/0%，P=0.001)。在恢复的患者中，A组6/7(86%)持续恢复，B组3/6(50%)恢复，32%的NICM患者在VAD时没有明显的左室扩张，大多数患者有显著的持续恢复。有严重左室扩张的患者恢复不明显。植入时的常规超声心动图可以帮助患者在VAD后恢复。
Myocardial recovery after VAD is rare but appears more common in non-ischemic cardiomyopathies (NICM). We sought to evaluate left ventricular (LV) end diastolic diameter (LVEDD) for predicting recovery after ventricular assist device (VAD). NICM patients receiving long-term mechanical support 1996–2008 were reviewed. Subjects were divided into 3 groups: mild, moderate and severe dilation (Group A: LVEDD <6.0 cm [n=22]; Group B: 6.0–7.0 cm [n=32]; Group C: >7.0 cm [n=48], respectively). Overall, recovery (successful explant without transplantation) occurred in 14 of 102 subjects (14%). Of these, 2 died and 2 required transplantation within one year. Recovery was more common in patients without LV dilation (Groups A/B/C = 32%/22%/0 %, P<0.001), as was sustained recovery (alive and transplant free one year after explant; A/B/C =27%/10%/0%, P=0.001). Of the recovery patients in Group A, 6/7 (86%) had sustained recovery versus 3/6 (50%) in Group B. Recovery occurred in 32% of NICM patients without significant LV dilation at time of VAD, the majority of whom experienced significant sustained recovery. Recovery was not evident in those with severe LV dilation. Routine echocardiography at the time of implant may assist in targeting patients for recovery after VAD.
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影响因子：
158.5
作者：
Rose, EA;Gelijns, AC;Meier, P
通讯作者：
Meier, P
影响因子：
4.6
作者：
Goldstein, DJ;Moazami, N;Oz, MC
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Sheppard, R;Bedi, M;McNamara, DM
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通讯作者：
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8.9
作者：
Gorcsan, J;Severyn, D;Kormos, RL
通讯作者：
Kormos, RL