Doshi Rajkumar, Patel Krunalkumar, Decter Dean, Gupta Rajeev, Meraj Perwaiz
Department of Cardiology, North Shore University Hospital, Northwell Health, Manhasset, New York, USA.
Department of Cardiology, Mediclinic Al Jowhara Hospital, Al Ain, United Arab Emirates.
Heart Lung Circ. 2019 Apr;28(4):e47-e50. doi: 10.1016/j.hlc.2018.03.025. Epub 2018 Apr 4.
Heart failure with reduced ejection fraction (HFrEF) is a systolic dysfunction with an ejection fraction below 40% and the prevalence of it is substantially increasing in the United States. Mechanical circulatory support (MCS) devices have increasingly been used for the management of HFrEF and are associated with improved outcomes. The National Inpatient Sample database was used to identify hospitalisations with mechanical circulatory support for HFrEF from 2005 to 2014. This study observed a reduction in the utilisation of intra-aortic balloon pump (IABP), which is partially replaced by percutaneous left ventricular assist device (pLVAD) and extracorporeal membrane oxygenation (ECMO) for the management of HFrEF. In-hospital mortality in IABP and ECMO recipients decreased during the study period while mortality with pLVAD did not change. Finally, technology for the short-term MCS in HFrEF hospitalisations continues to improve, however, there is still some space for updated technology in future.
射血分数降低的心力衰竭(HFrEF)是一种收缩功能障碍,射血分数低于40%,在美国其患病率正在大幅上升。机械循环支持(MCS)设备越来越多地用于HFrEF的管理,并与改善预后相关。利用国家住院样本数据库来确定2005年至2014年期间接受HFrEF机械循环支持的住院病例。本研究观察到主动脉内球囊泵(IABP)的使用减少,其部分被经皮左心室辅助装置(pLVAD)和体外膜肺氧合(ECMO)所取代,用于HFrEF的管理。在研究期间,IABP和ECMO接受者的院内死亡率下降,而pLVAD的死亡率没有变化。最后,HFrEF住院患者短期MCS的技术持续改进,然而,未来更新技术仍有一定空间。