NEJM:全磁悬浮离心式左心室辅助装用于晚期心衰患者

2019-04-26 MedSci MedSci原创

研究认为,在晚期心力衰竭患者中,与轴流式装置相比,全磁悬浮离心式左心室辅助装置对患者预后有利

近日研究人员比较了使用机械轴承轴流式左心室辅助装置与全磁悬浮离心式左心室辅助装置对晚期心力衰竭的患者发生泵血栓或非致残性卒中风险的影响。

晚期心力衰竭患者随机接受离心泵和轴流泵治疗,主要终点是2年生存率、无致残性卒中或再次手术替换或移除故障装置的复合终点。次级终点是2年后换泵率。

1028名患者,其中离心泵组516人,轴流泵组512人。在主要终点分析中,与轴流泵组332例(64.8%)患者相比,离心泵组397例(76.9%)患者在2年内仍存活,无致残性卒中或再次手术替换或移除故障装置(相对风险=0.84)。离心泵组更换泵的发生率低于轴流泵组(12例患者[2.3%]vs.57例患者[11.3%],相对风险=0.21)。离心泵组每患者年中发生严重中风、严重出血和肠道出血的事件数低于轴流泵组。

研究认为,在晚期心力衰竭患者中,与轴流式装置相比,全磁悬浮离心式左心室辅助装置对患者预后有利。

原始出处:

Mandeep R. Mehra et al. A Fully Magnetically Levitated Left Ventricular Assist Device - Final Report.N Engl J Med,April 25, 2019

本文系梅斯医学(MedSci)原创编译整理,转载需授权!

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (4)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=2029138, encodeId=6bc5202913806, content=<a href='/topic/show?id=d01e5982936' target=_blank style='color:#2F92EE;'>#晚期心衰#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59829, encryptionId=d01e5982936, topicName=晚期心衰)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b78f2500065, createdName=12498761m56暂无昵称, createdTime=Mon Jun 10 09:22:00 CST 2019, time=2019-06-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1373443, encodeId=1b2b13e3443ad, content=<a href='/topic/show?id=2fd051939ab' target=_blank style='color:#2F92EE;'>#心衰患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51939, encryptionId=2fd051939ab, topicName=心衰患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=467c360, createdName=yuanming7, createdTime=Sun Apr 28 00:22:00 CST 2019, time=2019-04-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1413254, encodeId=86511413254bf, content=<a href='/topic/show?id=1d7e48033f5' target=_blank style='color:#2F92EE;'>#左心室#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48033, encryptionId=1d7e48033f5, topicName=左心室)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=15012955474, createdName=wushaoling, createdTime=Sun Apr 28 00:22:00 CST 2019, time=2019-04-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034805, encodeId=778a1034805f4, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Fri Apr 26 12:22:00 CST 2019, time=2019-04-26, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=2029138, encodeId=6bc5202913806, content=<a href='/topic/show?id=d01e5982936' target=_blank style='color:#2F92EE;'>#晚期心衰#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59829, encryptionId=d01e5982936, topicName=晚期心衰)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b78f2500065, createdName=12498761m56暂无昵称, createdTime=Mon Jun 10 09:22:00 CST 2019, time=2019-06-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1373443, encodeId=1b2b13e3443ad, content=<a href='/topic/show?id=2fd051939ab' target=_blank style='color:#2F92EE;'>#心衰患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51939, encryptionId=2fd051939ab, topicName=心衰患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=467c360, createdName=yuanming7, createdTime=Sun Apr 28 00:22:00 CST 2019, time=2019-04-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1413254, encodeId=86511413254bf, content=<a href='/topic/show?id=1d7e48033f5' target=_blank style='color:#2F92EE;'>#左心室#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48033, encryptionId=1d7e48033f5, topicName=左心室)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=15012955474, createdName=wushaoling, createdTime=Sun Apr 28 00:22:00 CST 2019, time=2019-04-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034805, encodeId=778a1034805f4, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Fri Apr 26 12:22:00 CST 2019, time=2019-04-26, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=2029138, encodeId=6bc5202913806, content=<a href='/topic/show?id=d01e5982936' target=_blank style='color:#2F92EE;'>#晚期心衰#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59829, encryptionId=d01e5982936, topicName=晚期心衰)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b78f2500065, createdName=12498761m56暂无昵称, createdTime=Mon Jun 10 09:22:00 CST 2019, time=2019-06-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1373443, encodeId=1b2b13e3443ad, content=<a href='/topic/show?id=2fd051939ab' target=_blank style='color:#2F92EE;'>#心衰患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51939, encryptionId=2fd051939ab, topicName=心衰患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=467c360, createdName=yuanming7, createdTime=Sun Apr 28 00:22:00 CST 2019, time=2019-04-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1413254, encodeId=86511413254bf, content=<a href='/topic/show?id=1d7e48033f5' target=_blank style='color:#2F92EE;'>#左心室#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48033, encryptionId=1d7e48033f5, topicName=左心室)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=15012955474, createdName=wushaoling, createdTime=Sun Apr 28 00:22:00 CST 2019, time=2019-04-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034805, encodeId=778a1034805f4, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Fri Apr 26 12:22:00 CST 2019, time=2019-04-26, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=2029138, encodeId=6bc5202913806, content=<a href='/topic/show?id=d01e5982936' target=_blank style='color:#2F92EE;'>#晚期心衰#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59829, encryptionId=d01e5982936, topicName=晚期心衰)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b78f2500065, createdName=12498761m56暂无昵称, createdTime=Mon Jun 10 09:22:00 CST 2019, time=2019-06-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1373443, encodeId=1b2b13e3443ad, content=<a href='/topic/show?id=2fd051939ab' target=_blank style='color:#2F92EE;'>#心衰患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51939, encryptionId=2fd051939ab, topicName=心衰患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=467c360, createdName=yuanming7, createdTime=Sun Apr 28 00:22:00 CST 2019, time=2019-04-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1413254, encodeId=86511413254bf, content=<a href='/topic/show?id=1d7e48033f5' target=_blank style='color:#2F92EE;'>#左心室#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48033, encryptionId=1d7e48033f5, topicName=左心室)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=15012955474, createdName=wushaoling, createdTime=Sun Apr 28 00:22:00 CST 2019, time=2019-04-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034805, encodeId=778a1034805f4, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Fri Apr 26 12:22:00 CST 2019, time=2019-04-26, status=1, ipAttribution=)]
    2019-04-26 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

相关资讯

Circulation:染色质的CTCF环参与心衰应激性基因表达

在细胞核中,人类基因组具有三维空间结构,折叠形成数千个染色质环,包裹基因和顺式调控元件,以精准调控基因表达。染色质环由DNA结合蛋白CTCF和内聚蛋白环复合物锚定。鉴于心衰存在标志性的基因表达变化,近期有研究报道,CTCF相关的染色质重组是心肌应激性基因表达的基础,与CTCF敲除过程中所发生的染色质结构域边界的变化一致。研究人员采用心肌压力超负荷的小鼠模型和特异性敲除心肌Ctcf的小鼠模型,对染色

NEJM:新疗法可助降低糖尿病人肾衰、心衰风险

澳大利亚研究人员在新一期美国《新英格兰医学杂志》上报告,他们开发的一种新疗法可将糖尿病人的肾衰竭发病风险降低三分之一。

Heart:射血分数保留vs.射血分数降低心衰患者的预后和NT-proBNP

这项研究强调并证实了NT-proBNP水平在HFpEF患者中可以提供与HFrEF相同的相对风险信息。

2019 HFSA共识声明:心衰患者的营养,肥胖和恶病质

2019年3月,美国心衰学会(HFSA)发布了心衰患者的营养,肥胖和恶病质共识,心衰患者的饮食指导传统上侧重于限制钠和液体的摄入,但是心衰患者的饮食质量往往很差。本文主要目的是综合有关饮食质量、微生物补充、以及肥胖和恶病质管理的的现有证据,提供相关的共识建议。

真实病例分享:急性心衰稳定后早期应用ARNI获益更多!

患者缘于2天前饱食后开始出现胸痛,为全胸部闷痛,右肋下为主,伴胸闷,持续1-2小时后可自行缓解,频发发作,数小时发作一次,与进食无明显相关,静息状态下亦可发作,伴爬二楼或行走一百米后气促、喘息、乏力,伴咳嗽,呈干咳,无发热畏寒,无端坐呼吸,夜间可平卧入睡,无双下肢浮肿等。

JACC:ACEI/ARB可预防左室辅助装置相关胃肠道出血

对于严重心衰患者来说,心脏移植是最好的治疗方案,但由于供体有限,很多患者需要等待。在等待心脏移植的过程中,部分患者需要机械循环支持来改善心功能、提高生活质量,其中左室辅助装置最常用。但是,安装连续流动左室辅助装置也有风险,胃肠道出血就是常见的不良事件,文献报道其发生率为15%~40%,其中高达50%的胃肠道出血与动静脉畸形有关。近期发表在JACC上的一项研究表明,血管紧张素转换酶抑制剂(ACEI)