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结构性心脏病中左心室功能障碍的心力衰竭干预措施。

Heart Failure Interventions Targeting Impaired Left Ventricles in Structural Heart Disease.

机构信息

Department of Cardiology, Asklepios Klinik St. Georg, Lohmühlenstr. 5, 20099, Hamburg, Germany.

出版信息

Curr Cardiol Rep. 2018 Feb 12;20(2):8. doi: 10.1007/s11886-018-0950-6.

Abstract

PURPOSE OF REVIEW

Interventional techniques have been developed for a wide spectrum of mechanisms of heart failure (HF), especially in valvular heart disease and cardiomyopathies (ischaemic cardiomyopathy and hypertrophic cardiomyopathy). In this article, we review recent reports on catheter interventions to treat patients with HF.

RECENT FINDINGS

Direct modification using the Parachute device and the REVIVENT-TC device for patients with impaired left ventricle with large infarct scars improves geometry and haemodynamic efficiency, resulting in a reduction of HF symptoms. Interatrial shunt therapy improves symptoms and quality of life in HF patients. Uniquely, left ventricular outflow tract obstruction has also been targeted in patients with transcatheter mitral valve implantation. For advanced stage HF patients with prohibitively high surgical risk, emerging transcatheter interventions make it possible to modify life-limiting symptoms. Further results on HF interventions are expected from ongoing clinical trials.

摘要

目的综述

介入技术已经针对心力衰竭(HF)的广泛机制得到发展,特别是在瓣膜性心脏病和心肌病(缺血性心肌病和肥厚型心肌病)中。在本文中,我们回顾了最近关于导管介入治疗 HF 患者的报道。

最近的发现

使用 Parachute 装置和 REVIVENT-TC 装置对左心室功能障碍且有大梗死瘢痕的患者进行直接修正,可改善几何形状和血液动力学效率,从而减少 HF 症状。房间隔分流治疗可改善 HF 患者的症状和生活质量。独特的是,经导管二尖瓣植入术也针对左心室流出道梗阻的患者进行了靶向治疗。对于手术风险极高的晚期 HF 患者,新兴的经导管介入治疗使减轻危及生命的症状成为可能。正在进行的临床试验有望为 HF 干预措施带来更多结果。

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