PROPHELLA 概念在暴发性心肌炎中的作用机制。
Mode-of-action of the PROPELLA concept in fulminant myocarditis.
机构信息
Department of Internal Medicine and Cardiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow Klinikum, Augustenburger Platz 1, Berlin, Germany.
Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, BIH/Berlin-Brandenburg Center for Regenerative Therapies, Campus Virchow Klinikum, Föhrerstrasse 15, Berlin, Germany.
出版信息
Eur Heart J. 2019 Jul 1;40(26):2164-2169. doi: 10.1093/eurheartj/ehz124.
AIMS
Haemodynamic load induces cardiac remodelling via mechano-transduction pathways, which can further trigger inflammatory responses. We hypothesized that particularly in an inflammatory disorder such as myocarditis, a therapeutic strategy is required which, in addition to providing adequate circulatory support, unloads the left ventricle, decreases cardiac wall stress, and mitigates inflammatory responses.
METHODS AND RESULTS
Axial flow pumps such as the Impella systems comply with these requirements. Here, we report a potential mode-of-action of prolonged Impella support (PROPELLA concept) in fulminant myocarditis, including a decrease in cardiac immune cell presence, and integrin α1, α5, α6, α10 and β6 expression during unloading.
CONCLUSION
PROPELLA may provide benefits beyond its primary function of mechanical circulatory support in the form of additional disease-altering effects, which may contribute to enhanced myocardial recovery/remission in patients with chronic fulminant myocarditis.
目的
血流动力负荷通过机械转导途径诱导心脏重构，这可能进一步引发炎症反应。我们假设，在心肌炎等炎症性疾病中，除了提供足够的循环支持外，还需要一种治疗策略来减轻左心室负荷、降低心脏壁应力，并减轻炎症反应。
方法和结果
轴流泵，如 Impella 系统，符合这些要求。在这里，我们报告了在暴发性心肌炎中长时间使用 Impella 支持（PROPELLA 概念）的潜在作用模式，包括在卸载过程中心脏免疫细胞存在和整合素 α1、α5、α6、α10 和 β6 表达的减少。
结论
PROPELLA 除了提供机械循环支持的主要功能外，还可能通过额外的疾病改变作用带来益处，这可能有助于慢性暴发性心肌炎患者的心肌恢复/缓解。
Zotero 插件