INTERMACS Profiles of Advanced Heart Failure: The Current Picture
INTERMACS Profiles of Advanced Heart Failure: The Current Picture
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DOI：
10.1016/j.healun.2009.02.015
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发表时间：
2009-06-01
影响因子：
8.9
通讯作者：
Kirklin, James K.
中科院分区：
文献类型：
--
作者：
Stevenson, Lynne Warner;Pagani, Francis D.;Kirklin, James K.
背景：目前纽约心脏协会 IV 级症状患者的分类没有提供足够的描述，以便为当前的药物和起搏治疗、心脏移植和机械循环支持选择提供最佳的患者选择。方法：在机械辅助循环支持机构间登记处 (INTERMACS) 数据收集的第一年中，开发并实施了七种临床特征和心律失常修正剂。 INTERMACS 协调员委员会提供了有关接受植入设备的患者特征的持续反馈。结果：7 种临床概况的定义显示，80% 的当前设备正在临床妥协程度最高的 2 种概况中使用。 INTERMACS 协调员委员会帮助确定了使用临时辅助装置的住院患者和有静息症状的居家患者的特征之间的差距，这导致修订了配置文件 3 和 4 的定义，并添加了 2 个新的修饰符，用于医院临时循环支持装置以及在家中频繁再住院的患者。结论：现在可以使用 7 个配置文件加 3 个修饰符对考虑使用机械循环支持的患者进行分类INTERMACS。进一步了解这些概况及其对结果的影响应有助于更好地选择疾病晚期的患者和治疗方法。心肺移植杂志 2009；28：535-41。国际心肺移植协会版权所有 (C) 2009。
Background: The current classification of patients with New York Heart Association Class IV symptoms does not offer adequate description to allow optimal selection of patients for the current options of medical and pacing therapies, cardiac transplantation and mechanical circulatory support.Methods: Seven clinical profiles and an arrhythmia modifier were developed and implemented into the first year of data collection for the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS). The INTERMACS Coordinators' Council provided ongoing feedback regarding the characterization of patients receiving implantable devices.Results: The definition of 7 clinical profiles revealed that 80% of current devices are being used in the 2 profiles with the highest levels of clinical compromise. The INTERMACS Coordinators' Council helped to identify gaps in the characterization of hospitalized patients on temporary assist devices and of homebound patients with resting symptoms, which has led to revised definitions of Profile 3 and 4 and the addition of 2 new modifiers, for temporary circulatory Support devices in the hospital, and for frequent rehospitalization of patients at home.Conclusions: Patients considered for mechanical circulatory Support can now be classified using the 7 profiles plus 3 modifiers developed through INTERMACS. Further understanding these profiles and their impact on outcome should help to better select patients and therapies in the advanced stages of disease. J Heart Lung Transplant 2009;28:535-41. Copyright (C) 2009 by the International Society for Heart and Lung Transplantation.