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首页> 外文期刊>ESC Heart Failure >Daily non‐invasive haemodynamic telemonitoring for efficacy evaluation of MitraClip? implantation in patients with advanced systolic heart failure
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Daily non‐invasive haemodynamic telemonitoring for efficacy evaluation of MitraClip? implantation in patients with advanced systolic heart failure

机译：每日无创血液动力学远程监测，以评估MitraClip？植入型收缩期心力衰竭患者

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Aim Patients with advanced systolic chronic heart failure frequently suffer from progressive functional mitral regurgitation. We report our initial experience in patients with an implanted pulmonary artery pressure (PAP) sensor, who developed severe mitral regurgitation, which was treated with the MitraClip system. We non‐invasively compared changes in PAP values in patients after MitraClip with PAP changes in patients without MitraClip. Methods and results Among 28 patients with New York Heart Association III heart failure with implanted PAP sensor for haemodynamic telemonitoring from a single centre, four patients (age 66?±?6?years, left ventricular ejection fraction 21?±?3%, and cardiac index 1.8?±?0.3) received a MitraClip procedure and were compared with 24 patients (age 72?±?8?years, left ventricular ejection fraction 26?±?9.9%, and cardiac index 2.0?±?1.0) without MitraClip procedure in a descriptive manner. Ambulatory PAP values were followed for 90?days in both groups. In comparison with the PAP values 4?weeks before MitraClip procedure, PAP was profoundly reduced in all four patients after 30?days (ΔPAPmean ?11?±?5, ΔPAPdiast ?7?±?3?mmHg, P ??0.02) as well as after 90?days (ΔPAPmean ?6.3?±?6, ΔPAPdiast ?1?±?3?mmHg). Reductions in PAP were accompanied by a profound reduction in N terminal pro brain natriuretic peptide as well as clinical and echocardiographic improvement. When analysing the dynamics with a regression model, reductions in all PAP values were significantly greater after MitraClip compared with conservative haemodynamic monitoring ( P ??0.001). Conclusions The efficacy of the interventional MitraClip procedure on clinical symptoms can be confirmed by haemodynamic telemonitoring. Thus, daily non‐invasive haemodynamic telemonitoring allows, for the first time, for a continuous assessment of the haemodynamic efficacy of novel therapies in patients with chronic heart failure.
机译：目的患有晚期收缩期慢性心力衰竭的患者经常患有进行性二尖瓣反流。我们报告了我们在植入肺动脉压力（PAP）传感器的患者中的初步经验，该患者发生了严重的二尖瓣反流，并用MitraClip系统进行了治疗。我们对非MitraClip患者的PAP值变化与非MitraClip患者的PAP值进行了非侵入式比较。方法和结果在来自单个中心的28例植入了PAP传感器的纽约心脏协会III心力衰竭患者中进行血液动力学远程监控的患者中，有4例患者（年龄66？±6？岁，左心室射血分数21％±3％，以及心脏指数1.8？±？0.3）接受MitraClip手术，并与未使用MitraClip的24例患者（年龄72？±？8？年，左室射血分数26？±？9.9％，心脏指数2.0？±？1.0）进行比较。以描述性方式进行操作。两组均追踪动态PAP值90天。与MitraClip手术前4周的PAP值相比，四天后30天后所有患者的PAP均显着降低（ΔPAPmean≤11≤±5，ΔPAPast≤≤7≤±3≤mmHg，P≤<0.02。以及90天后（ΔPAPmean≤6.3±±6，ΔPAPdiast≤1≤±3≤mmHg）。 PAP的减少伴随着N末端前脑利钠肽的大量减少以及临床和超声心动图的改善。当用回归模型分析动力学时，与保守的血流动力学监测相比，MitraClip后所有PAP值的降低都明显更大（P 0.001）。结论血液动力学远程监测可以证实MitraClip介入治疗对临床症状的疗效。因此，每天进行的非侵入性血液动力学远程监护首次允许连续评估新型疗法对慢性心力衰竭患者的血液动力学功效。

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