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采用 Parachute 装置行经皮心室修复术(PVR)治疗 100 例缺血性扩张型心力衰竭患者:PARACHUTE III 欧洲试验一年主要终点结果。

Percutaneous ventricular restoration (PVR) therapy using the Parachute device in 100 subjects with ischaemic dilated heart failure: one-year primary endpoint results of PARACHUTE III, a European trial.

机构信息

St. Thomas' Hospital, London, United Kingdom.

出版信息

EuroIntervention. 2015 Oct;11(6):710-7. doi: 10.4244/EIJV11I6A143.

Abstract

AIMS

This prospective, non-randomised, observational study conducted in Europe was designed in order to assess the long-term safety and efficacy of the Parachute device in ischaemic heart failure subjects as a result of left ventricle remodelling after anterior wall myocardial infarction.

METHODS AND RESULTS

One hundred subjects with New York Heart Association Class II-IV ischaemic heart failure (HF), ejection fraction (EF) between 15% and 40%, and dilated akinetic or dyskinetic anterior-apical wall without the need to be revascularised were enrolled. The primary safety endpoint was procedural- or device-related major adverse cardiac cerebral events (MACCE). The secondary safety endpoint was the composite of mortality and morbidity. Secondary efficacy endpoints included haemodynamic measurements determined by echocardiography, LV volume indices, and assessment of functional improvement measured by a standardised six-minute walk test. Of the 100 subjects enrolled, device implantation was successful in 97 (97%) subjects. The one-year rates of the primary and secondary safety endpoints were 7% and 32.3%, respectively. The secondary endpoints, LV volume reduction (p<0.0001) and six-minute walk distance improvement (p<0.01), were achieved.

CONCLUSIONS

The favourable outcomes observed in this high-risk population provide reassuring safety and efficacy data to support adoption of this technology as a therapeutic option for HF subjects.

摘要

目的

这项在欧洲进行的前瞻性、非随机、观察性研究旨在评估 Parachute 装置在因前壁心肌梗死后左心室重构而导致缺血性心力衰竭患者中的长期安全性和疗效。

方法和结果

共纳入 100 例纽约心脏协会(NYHA)心功能分级 II-IV 级、射血分数(EF)在 15%-40%之间、存在扩张性无运动或运动不良的前壁顶区且无需血运重建的缺血性心力衰竭患者。主要安全性终点是手术或器械相关的主要不良心脑事件(MACCE)。次要安全性终点是死亡率和发病率的复合终点。次要疗效终点包括超声心动图确定的血流动力学测量、LV 容积指数和通过标准化六分钟步行试验评估的功能改善。在纳入的 100 例患者中,97 例(97%)患者成功植入了器械。主要和次要安全性终点的一年发生率分别为 7%和 32.3%。LV 容积减少(p<0.0001)和六分钟步行距离改善(p<0.01)等次要终点均达到。

结论

在这一高危人群中观察到的良好结果提供了令人安心的安全性和疗效数据,支持将该技术作为心力衰竭患者的一种治疗选择。

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