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微轴流泵(Impella CP®)在 ST 段抬高型心肌梗死合并心源性休克患者中的应用。

Microaxial flow pump (Impella CP®) in patients with ST-elevation myocardial infarction complicated by cardiogenic shock.

机构信息

Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.

Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.

出版信息

Kardiol Pol. 2024;82(7-8):702-707. doi: 10.33963/v.phj.102017. Epub 2024 Aug 14.

Abstract

Cardiogenic shock due to ST-elevation myocardial infarction remains a critical condition with a high mortality rate, even with current revascularization techniques. The use of mechanical circulatory support, such as the microaxial flow pump device (Impella CP®), presents a promising approach to enhance cardiac output and systemic perfusion. The DanGer Shock trial explored the efficacy of Impella CP® in addition to standard care compared to standard care alone in improving survival outcomes for these patients. Despite the potential for increased adverse events, the Impella CP® device significantly reduces mortality in patients with ST-elevation myocardial infarction complicated by cardiogenic shock. Future research should focus on refining patient selection criteria and minimizing device-related complications to maximize the therapeutic benefits of mechanical circulatory support in this critical population.

摘要

由于 ST 段抬高型心肌梗死导致的心源性休克仍然是一种危急情况,死亡率很高,即使采用目前的血运重建技术也是如此。使用机械循环支持,如微轴流泵装置(Impella CP®),为提高心输出量和全身灌注提供了一种有前途的方法。DanGer Shock 试验探讨了 Impella CP®在标准治疗基础上加用与单独标准治疗相比,对改善这些患者生存结局的疗效。尽管可能会增加不良事件,但 Impella CP®装置可显著降低 ST 段抬高型心肌梗死并发心源性休克患者的死亡率。未来的研究应集中于细化患者选择标准和最小化器械相关并发症,以最大限度地提高机械循环支持在这一危急人群中的治疗效益。

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