Jacquet L, Zerbe T, Stein K L, Kormos R L, Griffith B P
Division of Critical Care Medicine, University of Pittsburgh School of Medicine, Pa.
J Thorac Cardiovasc Surg. 1991 Feb;101(2):256-9.
In animal models using left ventricular assist systems over long time periods, myocardial cellular atrophy has been reported, raising concern that prolonged clinical use of such systems might lead to deterioration in left ventricular function. At the University of Pittsburgh, long-term clinical use of the Novacor (Baxter Healthcare Corp., Novacor Div., Oakland, Calif.) left ventricular support system for patients awaiting heart transplants has allowed study of the effects of long-term mechanical support on human subjects. This study determined that cardiac myocyte dimension is initially greater in patients with end-stage cardiac disease who require support rather than in patients with the same disease who do not require such support. Although myocyte dimension does decrease within a few days of the inception of support, this decrease merely brings cell size closer to the values usual in patients with chronic end-stage cardiac disease, and no further shrinkage is observed. Thus the Novacor left ventricular assist system does not appear associated with left ventricular atrophy, and its long-term use may not be detrimental to left ventricular function.
在长期使用左心室辅助系统的动物模型中，已有心肌细胞萎缩的报道，这引发了人们对长期临床使用此类系统可能导致左心室功能恶化的担忧。在匹兹堡大学，诺瓦科尔（巴克斯特医疗保健公司，诺瓦科尔分部，加利福尼亚州奥克兰）左心室支持系统在等待心脏移植的患者中的长期临床应用，使得对长期机械支持对人体影响的研究成为可能。这项研究确定，需要支持的终末期心脏病患者的心肌细胞尺寸最初比不需要此类支持的同病患者更大。尽管在支持开始后的几天内心肌细胞尺寸确实会减小，但这种减小仅仅使细胞大小更接近慢性终末期心脏病患者的常见值，且未观察到进一步的缩小。因此，诺瓦科尔左心室辅助系统似乎与左心室萎缩无关，其长期使用可能不会对左心室功能产生不利影响。
