长期糖尿病患者植入连续血流左心室辅助装置后的体位性低血压

Orthostatic Hypotension After Continuous-Flow Left Ventricular Assist Device Implantation in a Patient With Longstanding Diabetes Mellitus.

作者信息

Chew Derek S, Shaw Brett H, Isaac Debra L, Howlett Jonathan G, Raj Satish R

机构信息

Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada.

出版信息

Can J Cardiol. 2017 Apr;33(4):555.e5-555.e7. doi: 10.1016/j.cjca.2016.10.025. Epub 2016 Oct 28.

DOI:10.1016/j.cjca.2016.10.025

PMID:28024941

Abstract

A continuous-flow left ventricular assist device (CF-LVAD) benefits patients with advanced heart failure as a bridge to cardiac transplantation. However, unanticipated complications may occur. We report a patient with end-stage heart failure and longstanding diabetes who experienced functionally debilitating orthostatic hypotension from autonomic insufficiency after CF-LVAD implantation. This case demonstrates a role for comprehensive autonomic function testing in the workup of orthostatic hypotension after LVAD implantation.

摘要

连续流左心室辅助装置（CF-LVAD）作为心脏移植的桥梁，使晚期心力衰竭患者受益。然而，可能会出现意想不到的并发症。我们报告了一例终末期心力衰竭且患有长期糖尿病的患者，该患者在植入CF-LVAD后因自主神经功能不全出现了导致功能障碍的体位性低血压。该病例表明，全面的自主神经功能测试在LVAD植入后体位性低血压的检查中具有重要作用。