Seo Yong Gon, Park Won Hah, Oh SuKi, Sung Jidong, Jeon Eun Seok, Choi Jin Oh, Oh Jae K, Kim Yun Hee, Kim Ho Young, Jang Mi Ja, Choi Nam Gyung, Cho Yang Hyun
Division of Sports Medicine, Department of Orthopedic Surgery, Samsung Medical Center, Seoul, Korea.
Division of Cardiology, Department of Internal Medicine, Samsung Medical Center, Seoul, Korea.
J Exerc Rehabil. 2019 Jun 30;15(3):481-487. doi: 10.12965/jer.1938124.062. eCollection 2019 Jun.
In Korea, the first patient with a left ventricular assist device (LVAD) for destination therapy had successful implantation of a continuous-flow model in 2012. We investigated the safety and efficacy of exercise therapy with LVAD implantation 15 Korean patients. We retrospectively reviewed 15 patients (mean age, 67.4±11.6 years; 10 males, 5 female, left ventricular ejection fraction 23.6%±7.1%), including 4 with implanted continuous-flow and 11 an axial-flow LVAD. The New York Heart Association functional classification, ejection fraction, and quality of life were obtained. Survival rate, adverse events, admission rates, and enrollment rates in cardiac rehabilitation were investigated. Survival at 6 and 12 months was 100% and 89%, respectively. The New York Heart Association functional classification improved from 3.4±0.5 to 2.3±0.05 at 12 months postoperatively (<0.0001). The ejection fraction significantly increased from 23.6%±7.2% on the preoperative day to 35.4%±14.2% at 1 year (<0.0018). The quality of life was also improved at 1 year (<0.0001). The most common adverse events were bleeding (56%) and dyspnea (44%). The number of admissions was 3.2 per patient-year. LVAD therapy is a safe and effective treatment option with exercise intervention for Korean patients waiting for heart transplantation or those who were ineligible for heart transplantation. A larger study with longer follow-up is needed to determine details clinical outcomes after LVAD.
在韩国,首例接受左心室辅助装置(LVAD)进行目标治疗的患者于2012年成功植入了连续流模型。我们调查了15例植入LVAD的韩国患者运动疗法的安全性和有效性。我们回顾性分析了15例患者(平均年龄67.4±11.6岁;男性10例,女性5例,左心室射血分数23.6%±7.1%),其中4例植入了连续流LVAD,11例植入了轴流LVAD。获取了纽约心脏协会功能分级、射血分数和生活质量。调查了生存率、不良事件、入院率和心脏康复的参与率。6个月和12个月时的生存率分别为100%和89%。术后12个月时纽约心脏协会功能分级从3.4±0.5改善至2.3±0.05(<0.0001)。射血分数从术前的23.6%±7.2%显著增加至1年时的35.4%±14.2%(<0.0018)。1年时生活质量也有所改善(<0.0001)。最常见的不良事件是出血(56%)和呼吸困难(44%)。每位患者每年的入院次数为3.2次。对于等待心脏移植或不符合心脏移植条件的韩国患者,LVAD治疗是一种安全有效的治疗选择,并可进行运动干预。需要进行更大规模、随访时间更长的研究来确定LVAD术后的详细临床结局。