首页|心肌收缩调节器在心力衰竭患者中的短期有效性及安全性研究

心肌收缩调节器在心力衰竭患者中的短期有效性及安全性研究

Short-term efficacy and safety of cardiac contractility modulation in patients with heart failure

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目的 探讨心肌收缩调节器(CCM)在心力衰竭患者中的短期有效性及安全性.方法 该研究为横断面研究,纳入2022年2至6月于新疆医科大学第一附属医院接受CCM置入的心力衰竭患者.随访3个月,监测CCM感知、阻抗、输出百分比、工作时间,比较患者术前及术后3个月左心室射血分数值(LVEF)、6min步行试验距离和纽约心脏协会(NYHA)心功能分级,记录并发症及不良事件发生情况.结果 纳入的9例患者均成功置入CCM.其中男性7例,年龄(56±14)岁,3例患者为缺血性心肌病,6例患者为扩张性心肌病.术后3个月随访结果显示,CCM阈值平稳,感知较术中下降[右心室:(8.2±1.1)mV 比(16.3±7.0)mV,P<0.05;局部感知电极:(6.7±2.5)mV 比(15.7±4.9)mV,P<0.05],阻抗较术中明显下降[右心室:(470±65)Ω比(846±179)Ω,P<0.05;局部感知电极:(464±63)Ω比(832±246)Ω,P<0.05];CCM 输出百分比为(86.9±10.7)%,输出幅度为(6.7±0.4)V,工作时间为(8.6± 1.0)h/d.患者LVEF较术前升高[(38.3±4.3)%比(29.4±5.2)%,P<0.05],6 min步行试验距离较术前延长[(289.3±121.7)m 比(96.8±66.7)m,P<0.05],NYHA Ⅲ~Ⅳ级患者比例下降,但差异无统计学意义(2/9比7/9,P>0.05).患者未有因心力衰竭症状加重再次入院,无恶性心律失常事件发生,且胸闷、气短等症状明显缓解.术后未发现囊袋血肿、囊袋感染及破溃、电极脱落、瓣膜功能损害、心包积液、心脏穿孔等相关并发症.结论 CCM具有较好的短期安全性及有效性.
Objective To investigate the short-term efficacy and safety of cardiac contractility modulation(CCM)in patients with heart failure.Methods This was a cross-sectional study of patients with heart failure who underwent CCM placement at the First Affiliated Hospital of Xinjiang Medical University from February to June 2022.With a follow-up of 3 months,CCM sensation,impedance,percent output,and work time were monitored,and patients were compared with pre-and 3-month postoperative left ventricular ejection fraction(LVEF)values,and 6-minute walk test distance and New York Heart Association(NYHA)cardiac function classification,and the occurrence of complications was recorded.Results CCM was successfully implanted in all 9 patients.Seven(7/9)of them were male,aged(56±14)years,3 patients had ischaemic cardiomyopathy and 6 patients had dilated cardiomyopathy.At 3-month postoperative follow-up,threshold was stable,sense was significantly lower at follow-up than before(right ventricle:(16.3± 7.0)mV vs.(8.2±1.1)mV,P<0.05;local sense:(15.7±4.9)mV vs.(6.7±2.5)mV,P<0.05),and impedance was significantly lower at follow-up than before(right ventricle(846±179)Ω vs.(470± 65)Ω,P<0.05,local sense:(832±246)Ω vs.(464±63)Ω,P<0.05).The CCM output percentage was(86.9±10.7)%,the output amplitude was(6.7±0.4)V,and the daily operating time was(8.6±1.0)h.LVEF was elevated compared to preoperative((29.4±5.2)%vs.(38.3±4.3)%,P<0.05),the 6-minute walk test was significantly longer than before((96.8±66.7)m vs.(289.3±121.7)m,P<0.05).No significant increase in the number of NYHA Class Ⅲ-Ⅳ patients was seen(7/9 vs.2/9,P>0.05).The patient was not re-hospitalised for worsening heart failure symptoms,had no malignant arrhythmic events and experienced significant relief of symptoms such as chest tightness and shortness of breath.No postoperative complications related to pocket hematoma,pocket infection and rupture,electrode detachment,valve function impairment,pericardial effusion,or cardiac perforation were found.Conclusions CCM has better short-term safety and efficacy in patients with heart failure.

Heart failureCardiac contractility modulation6-minute walk test

郭衍楷、尚帅、孙天恒、樊永强、贾索尔·肖克热提、祖克拉·吐尔洪、杨徐、张玲、李耀东、芦颜美、张疆华、邢强、周贤惠、汤宝鹏

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新疆医科大学第一附属医院心脏中心起搏电生理科 新疆心电生理与心脏重塑重点实验室,乌鲁木齐 830054

心力衰竭 心肌收缩调节器 6 min步行试验

新疆维吾尔自治区自然科学基金青年科学基金新疆维吾尔自治区区域协同创新专项(科技援疆计划)新疆维吾尔自治区自然科学基金省部共建中亚高发病成因与防治国家重点实验室开放基金国家重点研发计划精准医学研究心力衰竭队列建设项目

2022D01C7672020E02742021D01C450SKL-HIDCA-2022-XXG42016YFC0900905

2024

中华心血管病杂志
中华医学会

中华心血管病杂志

CSTPCD北大核心
影响因子:2.846
ISSN:0253-3758
年,卷(期):2024.52(4)
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