Passive Containment and Reverse Remodeling by a Novel Textile Cardiac Support Device
Passive Containment and Reverse Remodeling by a Novel Textile Cardiac Support Device
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新型纺织心脏支持装置的被动遏制和逆向重塑
DOI：
10.1161/hc37t1.094525
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发表时间：
2001
期刊：
影响因子：
--
通讯作者：
F. Kleber
中科院分区：
文献类型：
--
作者：
W. Konertz;J. Shapland;H. Hotz;S. Dushe;J. Braun;K. Stantke;F. Kleber
背景——心室的渐进性重塑和扩张是慢性心力衰竭心肌功能障碍的部分原因。使用合适的动物模型进行的临床前研究表明，被动心脏约束装置可以促进逆向重塑，从而改善心脏功能。我们假设这种装置可以为纽约心脏协会 (NYHA) II 级和 III 级稳定心力衰竭患者带来益处。方法和结果——从 1999 年 4 月到 2000 年 3 月，27 名患者在最初的安全性/可行性研究中接受了 Acorn 的心脏支持装置 (CSD)。在 11 名患者中，唯一的手术措施是放置 CSD。大多数患者患有特发性心肌病； 4 例为 NYHA II 级，1 例为 II/III 级，6 例为 III 级。所有人都在接受强化治疗，病情稳定。 CSD 是一种纺织聚酯装置，在手术过程中紧密地安装在心脏周围。所有患者均顺利完成手术并康复。术后三个月，56% 的患者属于 NYHA I 级，33% 属于 II 级，11% 属于 II/III 级。超声心动图显示左心室射血分数在 3 个月和 6 个月时分别从平均 22% 改善至 28% 和 33%。同时，左心室舒张末期尺寸分别从 74 毫米减少至 68 毫米和 65 毫米。 3 个月内，二尖瓣关闭不全（评分为 0 至 4+）从 1.3 降至 0.7。生活质量指数与心室重构的明显逆转相关。植入后术前心脏药物几乎保持不变。结论——在短期和中期，CSD 植入似乎可以改善心力衰竭患者的症状并改善心脏和功能表现。全球随机试验目前正在进行中。
Background—Progressive remodeling and dilation of cardiac chambers is responsible in part for myocardial dysfunction in chronic heart failure. Preclinical studies with suitable animal models indicate that a passive cardiac constraint device can promote reverse remodeling, with improvement in cardiac function. We hypothesize that such a device could provide benefit for stable heart failure patients in New York Heart Association (NYHA) class II and III . Methods and Results—From April 1999 to March 2000, 27 patients received Acorn’s Cardiac Support Device (CSD) during an initial safety/feasibility study. In 11 patients, the only surgical measure was CSD placement. Most patients suffered from idiopathic cardiomyopathy; 4 were in NYHA class II, one was in class II/III, and 6 were in class III. All were stable on intensive medical treatment. The CSD, a textile polyester device, was fitted snugly around the heart during surgery. All patients survived surgery and recovered smoothly. Three months after surgery, 56% of patients were in NYHA class I, 33% were in class II, and 11% were in class II/III. Echocardiography showed an improvement in left ventricular ejection fraction from an average of 22% to 28% and 33% at 3 and 6 months, respectively. Simultaneously, the left ventricular end-diastolic dimension decreased from 74 mm to 68 mm and 65 mm, respectively. Mitral valve regurgitation (on a scale of 0 to 4+) decreased from 1.3 to 0.7 by 3 months. Quality-of-life indices correlated with the apparent reversal of ventricular remodeling. Preoperative cardiac medications remained virtually unchanged after implant. Conclusions—In the short- and intermediate-term, CSD implantation seems to ameliorate symptoms and improve cardiac and functional performance in heart failure patients. Worldwide randomized trials are currently underway.
影响因子：
20.1
作者：
Pan, J;Fukuda, K;Ogawa, S
通讯作者：
Ogawa, S