Jimenez Yomary, Tsai Christina, Mrizigue Fatima, Ahmed Mustafa M
Division of Cardiovascular Medicine, University of Florida, Gainesville, FL, USA.
Department of Neuroscience, University of Washington, Seattle, WA, USA.
Future Cardiol. 2025 Sep 24:1-8. doi: 10.1080/14796678.2025.2564017.
Left ventricular assist devices have been demonstrated to improve both quality of life and improve survival in patients with end-stage heart failure. Ideal speed setting of these devices is necessary to provide adequate left ventricular unloading while not disadvantaging the right heart. This highlights the potential utility of speed titration studies.
PubMed, Scopus, and the Cumulative Index to Nursing and Allied Health Literature databases were searched for: (LVAD) OR (Left Ventricular Assist Device) OR (VAD) OR (Ventricular Assist Device) AND (Speed Optimization) OR (Ramp Study) from inception to April 2025.
22 studies with 749 total patients were included, 45% of whom had a Heart Mate 3. Outcomes of interest included mortality, readmission, RV function, speed change at conclusion of the study, and quality of life. Only 1 out of 22 studies reported all 5 outcomes, with 64% reporting 2 or fewer outcomes of interest.
There exists limited data on speed optimization in the HM3, and that which has been reported lacks a standardization regarding method of evaluation as well as outcomes reporting. Prospective studies, with a standard method of speed optimization and more detailed outcomes reporting, are necessary in order to define best practices.
左心室辅助装置已被证明可改善终末期心力衰竭患者的生活质量并提高生存率。这些装置的理想速度设置对于提供足够的左心室卸载同时又不给右心带来不利影响是必要的。这凸显了速度滴定研究的潜在效用。
对PubMed、Scopus以及护理与联合健康文献累积索引数据库进行检索，检索时间从数据库创建至2025年4月，检索词为：(LVAD) 或 (Left Ventricular Assist Device) 或 (VAD) 或 (Ventricular Assist Device) 以及 (Speed Optimization) 或 (Ramp Study)。
纳入了22项研究，共计749例患者，其中45%使用的是Heart Mate 3。感兴趣的结局包括死亡率、再入院率、右心室功能、研究结束时的速度变化以及生活质量。22项研究中只有1项报告了所有5个结局，64%的研究报告了2个或更少感兴趣的结局。
关于Heart Mate 3速度优化的数据有限，并且已报告的数据在评估方法和结局报告方面缺乏标准化。有必要进行前瞻性研究，采用标准化的速度优化方法并进行更详细的结局报告，以确定最佳实践。
