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Kalp Yetmezliğinde Etiyolojik ve Prognostik Değerlerin Beklenen Yaşam Süresine ve Mekanik Dolaşım Desteğinin Zamanlamasına Etkisi: Biyonik kalbe mi gidiyoruz?

Yıl 2022, Cilt: 4 Sayı: 2, 23 - 30, 31.12.2022

Öz

Amaç: Bu çalışmanın amacı, kalp yetmezliği olan hastalarda tanı için erken implantasyon kriterlerini, prognostik değerleri, yaşam sürecini ve mekanik dolaşım desteğini belirlemektir.
Yöntem: Çalışmaya 40 (Erkek, 33; Kadın, 7) hasta dahil edildi. Hastalar dilate, iskemik ve hipertrofik kardiyomiyopatili olarak gruplandırıldı. New York Kalp Cemiyeti kriterlerine göre sınıfları belirlendi ve kısa form 36 yaşam kalitesi değerlendirme anketi uygulandı. INTERMACS ® tesviye edildi. VO2 max ve 6 dakika yürüme testi, kan sodyum ve pro-BNP düzeyleri, LVEF, RVEF, sağ atriyal dolum basınçları incelendi.
Bulgular: Grupta dilate KMP, hipertrofik KMP ve iskemik KMP oranları sırasıyla %75, %5 ve %20 idi. Dört sınıflı NYHA sınıflamasına (I'den IV'e) göre hastaların oranları sırasıyla %5, %25, %47,5 ve %22,5 idi. Ortalama Intermacs seviyeleri 4,90 ± 1,59 ve 3,66 ± 1,22 ve VO2 max değerleri 13,52±6,02, altı dakikalık yürüme testine göre yürüme mesafeleri 280,55 ±131,94 metre, LVEF değerleri 23,10 ±6,73 idi. Yüksek sol ventrikül diyastol sonu çapı ve düşük VO2 max değerleri kötü prognoz ile ilişkilendirildi. Bağımsız değişken olarak sağ ventrikül ejeksiyon fraksiyonu ve altı dakika yürüme testi ölümle ilişkilendirildi.
Sonuç: Çalışmamıza göre mortalitesi yüksek olan kalp yetmezlikli seçilmiş hastalarda mekanik dolaşım desteği uygulanarak beklenen yaşam süresi arttırılabilir. Gelecekte giderek artan sayıda hastaya bu cihazların transplantasyona bir alternatif olarak implante edilmesi muhtemeldir ve hasta grubundan iskemik olmayan dilate kardiyomiyopatisi olanların tümü iyileşme için adaydır.

Kaynakça

  • Altes, A., Appert, L., Delelis, F., Guyomar, Y., Menet, A., Ennezat, PV., et al. (2019). Impact of right atrial size on long-term mortality in patients with heart failure receiving cardiac resynchronization therapy. Am J Cardiol, 123, 936-941.
  • Arenaza, DP., Flather, M., Lees, B., Rubinstein, F., Nugara, F., Cagide, A., et al. (2006). Role of preoperative 6 minute walk test in the assessment and prognosis of patients with severe aortic stenosis undergoing aortic valve replacement. Circulation,114, e478.
  • Bardy, GH., Lee, KL., Mark, DB., Poole, JE., Packer, DL., Boineau R, et al. (2005). Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. N Engl J Med, 352,225–237.
  • Birks, EJ., Tansley, PD., Hardy, J., George, RS., Bowles, CT., Burke, M., et al. (2006). Left ventricular assist device and drug therapy for the reversal of heart failure. N. Engl. J. Med, 355, 1873–1884.
  • Bleumink, GA., Knetsch, AM., Sturkenboom, MC., Straus, S., Hofman, A,. Deckers, JW., et al. (2004). Quantifying the heart failure epidemic: prevalence, incidence rate, lifetime risk and prognosis of heart failure: the Rotterdam Study. Eur Heart J, 25, 1614-1619.
  • Cavga, SH. (2022). Development of artificial heart devices. Res J Biomed Biotech, 3, 17-24. Clark, DO., Tu, W., Weiner, M., Murray, MD. (2003). Correlates of health-related quality of life among lower-income, urban adults with congestive heart failure. Heart Lung, 32, 391-401.
  • Copeland, JG., Smith, RG., Arabia, FA., Nolan, PE., Sethi, GK., Tsau, PH., et al. (2004). Cardiac replacement with a total artificial heart as a bridge to transplantation. N Engl J Med, 351,859–867.
  • McMurray, JJ., Adamopoulos, S., Anker, SD., Auricchio, A., Böhm, M., Dickstein, K., et al. (2012) ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in Collaboration With the Heart Failure Association (HFA) of the ESC. Eur Heart J, 33, 1787-1847.
  • Hobbs, FD., Kenkre, JE., Roalfe, AK., Davis, RC., Hare, R., Davies, MK. (2002). Impact of heart failure and left ventricular systolic dysfunction on quality of life: a cross sectional study comparing common chronic cardiac and medical disorders and a representative adult population. Eur Heart J, 23,1867–1876.
  • Isik, M., Velioglu, Y. (2021). Contribution of current comorbid conditions to carotid artery stenosis in patients undergoing coronary artery bypass and stroke distribution in carotid artery stenosis groups. Heart Surg For, 24,24-30.
  • Jenkinson, C., Jenkinson, D., Shepperd, S. (1997). Evaluation of treatment for congestive heart failure in patients aged 60 years and older using generic measures of health status (sf-36 and coop charts). Age Ageing, 26, 7–13.
  • Juenger, J., Schellberg, D., Kraemer, S., Haunstetter, A., Zugck, C., Herzog, W., et al. (2002). Health related quality of life in patients with congestive heart failure: comparison with other chronic diseases and relation to functional variables. Heart, 87,235–241.
  • Karapolat, H., Durmaz, B., Nalbantgil, S., Durmaz, I. (2006). Kalp yetersizliğinde yaşam kalitesi ve fonksiyonel durum. Anadolu Kardiyol Derg, 6, 327–332.
  • Kirklin, JK., Naftel, DC., Pagani, FD., Kormos, RL., Stevenson, LW., Blume, ED., et al. (2014). Sixth INTERMACS annual report: a 10,000-patient database. J Heart Lung Transplant ,33, 555-564.
  • Ladenvall, P., Persson, CU., Mandalenakis, Z., Wilhelmsen, L., Grimby, G., Svardsudd, K., et al. (2016). Low aerobic capacity in middle-aged men associated with increased mortality rates during 45 years of follow-up. Eur J Prev Cardiol, 23, 1557-1564.
  • Lainchbury, JG., Richards, AM. (2002). Exercise testing in the assessment of chronic congestive heart failure. Heart, 88, 538–543.
  • Lee, TF., Yua, SF., Woob, J., Thompson, DR. (2005). Health related quality of life in patients with congestive heart failure. Euro J Heart Fail, 7, 419–422.
  • Mayer, O., Šimon, J., Plášková, M., Cífková, R., Trefil, L. (2009). N-terminal pro B-type natriuretic peptide as prognostic marker for mortality in coronary patients without clinically manifest heart failure. Eur J Epidemiol, 24,363-368.
  • Meyer, P., Filippatos, GS., Ahmed, MI., Iskandrian, AE., Bittner, V., Perry, GJ., et al. (2010). Effects of right ventricular ejection fraction on outcomes in chronic systolic heart failure. Circulation, 121,252–258.
  • Moradi, M., Daneshi, F., Behzadmehr, R., Rafiemanesh, H., Bouya, S., Raeisi, M. (2020). Quality of life of chronic heart failure patients: a systematic review and meta-analysis. Heart Fail Rev, 25, 993-1006.
  • Poggin, R., Arazi, HC., Giorgi, M., Miriuka, SG. (2010). Prediction of severe cardiovascular events by VE/VCO2 slope versus peak VO2 in systolic heart failure: A meta-analysis of the published literature am heart. Am Heart J, 160,1004–1014.
  • Rose, EA., Gelinjs, AC., Moskowitz, AJ., Heitjan, DF., Stevenson, LW., Dembitsky, W., et al. (2001). Long-Term Use Of A Left Ventricular Assist Device For End-Stage Heart Failure. N Engl J Med, 345, 1435-1443.
  • Seferovic, PM., Vardas, P., Jankowska, EA., Maggioni, AP., Timmis, A., Milinkovic, I., et al. (2021). The heart failure association atlas: heart failure epidemiology and management statistics 2019. Euro J Heart Fail, 23, 906-914.
  • Slaughter, MS., Rogers, JG., Milano, CA., Russell, SD., Conte, JV., Feldman, D., et al. (2009). Advanced heart failure treated with continuous-flow left ventricular assist device. N Engl J Med, 361,2241–2251.
  • Stevenson, LW., Pagani, FD., Young, JB., Jessup, M., Miller, L., Kormos, RL., et al. (2009). INTERMACS profiles of advanced heart failure: the current picture. J Heart Lung Transplant, 28, 535-541.
  • Vis, A., Arfaee, M., Khambati, H., Slaughter, MS., Gummert, JF., Overvelde, JT., et al. (2022). The ongoing quest for the first total artificial heart as destination therapy. Nat Rev Cardiol, 19, 813-828.

The Effects of the Aetiologic and Prognostic Values in Heart Failure on Life Expectancy and the Timing of Mechanical Circulatory Support: Are we heading for the bionic heart?

Yıl 2022, Cilt: 4 Sayı: 2, 23 - 30, 31.12.2022

Öz

Objective: The aim of this study was to determine early implantation criteria for diagnosis, prognostic values, life process and mechanical circulatory support in patients with heart failure.
Method: 40 (male, 33; female, 7) patients were enrolled in the study. Patients were grouped as having dilated, ischemic and hypertrophic cardiomyopathy. New York Heart Association classes were determined, and a short-form 36 quality-of-life assessment questionnaire was administered. INTERMACS ® has been leveled. VO2 max and 6 minute walk test, blood sodium and pro-BNP levels, LVEF, RVEF, right atrial filling pressures were examined.
Results: Rates of the group of dilated CMP, hypertrophic CMP, and ischemic CMP were 75%, 5%, and 20%, respectively. Ratios of the patients according to four classed NYHA classification (I to IV) were 5%, 25%, 47.5%, and 22.5%, respectively. Mean Intermacs levels were 4.90 ± 1.59 and 3.66 ± 1.22 and VO2 max values were 13.52±6, 02, according to six-minute walk test, walking distances were 280.55 ±131.94 meters, LVEF values were 23.10 ±6.73. High left ventricle end diastolic diameter and low VO2 max values were associated with a poor prognosis. Right ventricular ejection fraction as independent variables and six-minute walk test were associated with death.
Conclusion: According to our study survey can be corrected by applying mechanical circulation support in selected patients for heart failure with high mortality. An increasing number of patients in the future are likely to have these devices implanted as an alternative to transplantation, and of these, all with nonischemic dilated cardiomyopathy are candidates for recovery.

Kaynakça

  • Altes, A., Appert, L., Delelis, F., Guyomar, Y., Menet, A., Ennezat, PV., et al. (2019). Impact of right atrial size on long-term mortality in patients with heart failure receiving cardiac resynchronization therapy. Am J Cardiol, 123, 936-941.
  • Arenaza, DP., Flather, M., Lees, B., Rubinstein, F., Nugara, F., Cagide, A., et al. (2006). Role of preoperative 6 minute walk test in the assessment and prognosis of patients with severe aortic stenosis undergoing aortic valve replacement. Circulation,114, e478.
  • Bardy, GH., Lee, KL., Mark, DB., Poole, JE., Packer, DL., Boineau R, et al. (2005). Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. N Engl J Med, 352,225–237.
  • Birks, EJ., Tansley, PD., Hardy, J., George, RS., Bowles, CT., Burke, M., et al. (2006). Left ventricular assist device and drug therapy for the reversal of heart failure. N. Engl. J. Med, 355, 1873–1884.
  • Bleumink, GA., Knetsch, AM., Sturkenboom, MC., Straus, S., Hofman, A,. Deckers, JW., et al. (2004). Quantifying the heart failure epidemic: prevalence, incidence rate, lifetime risk and prognosis of heart failure: the Rotterdam Study. Eur Heart J, 25, 1614-1619.
  • Cavga, SH. (2022). Development of artificial heart devices. Res J Biomed Biotech, 3, 17-24. Clark, DO., Tu, W., Weiner, M., Murray, MD. (2003). Correlates of health-related quality of life among lower-income, urban adults with congestive heart failure. Heart Lung, 32, 391-401.
  • Copeland, JG., Smith, RG., Arabia, FA., Nolan, PE., Sethi, GK., Tsau, PH., et al. (2004). Cardiac replacement with a total artificial heart as a bridge to transplantation. N Engl J Med, 351,859–867.
  • McMurray, JJ., Adamopoulos, S., Anker, SD., Auricchio, A., Böhm, M., Dickstein, K., et al. (2012) ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in Collaboration With the Heart Failure Association (HFA) of the ESC. Eur Heart J, 33, 1787-1847.
  • Hobbs, FD., Kenkre, JE., Roalfe, AK., Davis, RC., Hare, R., Davies, MK. (2002). Impact of heart failure and left ventricular systolic dysfunction on quality of life: a cross sectional study comparing common chronic cardiac and medical disorders and a representative adult population. Eur Heart J, 23,1867–1876.
  • Isik, M., Velioglu, Y. (2021). Contribution of current comorbid conditions to carotid artery stenosis in patients undergoing coronary artery bypass and stroke distribution in carotid artery stenosis groups. Heart Surg For, 24,24-30.
  • Jenkinson, C., Jenkinson, D., Shepperd, S. (1997). Evaluation of treatment for congestive heart failure in patients aged 60 years and older using generic measures of health status (sf-36 and coop charts). Age Ageing, 26, 7–13.
  • Juenger, J., Schellberg, D., Kraemer, S., Haunstetter, A., Zugck, C., Herzog, W., et al. (2002). Health related quality of life in patients with congestive heart failure: comparison with other chronic diseases and relation to functional variables. Heart, 87,235–241.
  • Karapolat, H., Durmaz, B., Nalbantgil, S., Durmaz, I. (2006). Kalp yetersizliğinde yaşam kalitesi ve fonksiyonel durum. Anadolu Kardiyol Derg, 6, 327–332.
  • Kirklin, JK., Naftel, DC., Pagani, FD., Kormos, RL., Stevenson, LW., Blume, ED., et al. (2014). Sixth INTERMACS annual report: a 10,000-patient database. J Heart Lung Transplant ,33, 555-564.
  • Ladenvall, P., Persson, CU., Mandalenakis, Z., Wilhelmsen, L., Grimby, G., Svardsudd, K., et al. (2016). Low aerobic capacity in middle-aged men associated with increased mortality rates during 45 years of follow-up. Eur J Prev Cardiol, 23, 1557-1564.
  • Lainchbury, JG., Richards, AM. (2002). Exercise testing in the assessment of chronic congestive heart failure. Heart, 88, 538–543.
  • Lee, TF., Yua, SF., Woob, J., Thompson, DR. (2005). Health related quality of life in patients with congestive heart failure. Euro J Heart Fail, 7, 419–422.
  • Mayer, O., Šimon, J., Plášková, M., Cífková, R., Trefil, L. (2009). N-terminal pro B-type natriuretic peptide as prognostic marker for mortality in coronary patients without clinically manifest heart failure. Eur J Epidemiol, 24,363-368.
  • Meyer, P., Filippatos, GS., Ahmed, MI., Iskandrian, AE., Bittner, V., Perry, GJ., et al. (2010). Effects of right ventricular ejection fraction on outcomes in chronic systolic heart failure. Circulation, 121,252–258.
  • Moradi, M., Daneshi, F., Behzadmehr, R., Rafiemanesh, H., Bouya, S., Raeisi, M. (2020). Quality of life of chronic heart failure patients: a systematic review and meta-analysis. Heart Fail Rev, 25, 993-1006.
  • Poggin, R., Arazi, HC., Giorgi, M., Miriuka, SG. (2010). Prediction of severe cardiovascular events by VE/VCO2 slope versus peak VO2 in systolic heart failure: A meta-analysis of the published literature am heart. Am Heart J, 160,1004–1014.
  • Rose, EA., Gelinjs, AC., Moskowitz, AJ., Heitjan, DF., Stevenson, LW., Dembitsky, W., et al. (2001). Long-Term Use Of A Left Ventricular Assist Device For End-Stage Heart Failure. N Engl J Med, 345, 1435-1443.
  • Seferovic, PM., Vardas, P., Jankowska, EA., Maggioni, AP., Timmis, A., Milinkovic, I., et al. (2021). The heart failure association atlas: heart failure epidemiology and management statistics 2019. Euro J Heart Fail, 23, 906-914.
  • Slaughter, MS., Rogers, JG., Milano, CA., Russell, SD., Conte, JV., Feldman, D., et al. (2009). Advanced heart failure treated with continuous-flow left ventricular assist device. N Engl J Med, 361,2241–2251.
  • Stevenson, LW., Pagani, FD., Young, JB., Jessup, M., Miller, L., Kormos, RL., et al. (2009). INTERMACS profiles of advanced heart failure: the current picture. J Heart Lung Transplant, 28, 535-541.
  • Vis, A., Arfaee, M., Khambati, H., Slaughter, MS., Gummert, JF., Overvelde, JT., et al. (2022). The ongoing quest for the first total artificial heart as destination therapy. Nat Rev Cardiol, 19, 813-828.
Toplam 26 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Halk Sağlığı, Çevre Sağlığı
Bölüm Araştırma Makaleleri
Yazarlar

Gökalp Güzel 0000-0003-0377-3095

Özgür Altınbaş 0000-0002-6819-2454

Erhan Hafız 0000-0002-0801-3194

Haşim Ustunsoy 0000-0003-0282-9114

Yayımlanma Tarihi 31 Aralık 2022
Gönderilme Tarihi 23 Kasım 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 4 Sayı: 2

Kaynak Göster

APA Güzel, G., Altınbaş, Ö., Hafız, E., Ustunsoy, H. (2022). The Effects of the Aetiologic and Prognostic Values in Heart Failure on Life Expectancy and the Timing of Mechanical Circulatory Support: Are we heading for the bionic heart?. Doğal Yaşam Tıbbı Dergisi, 4(2), 23-30.
AMA Güzel G, Altınbaş Ö, Hafız E, Ustunsoy H. The Effects of the Aetiologic and Prognostic Values in Heart Failure on Life Expectancy and the Timing of Mechanical Circulatory Support: Are we heading for the bionic heart?. DYT. Aralık 2022;4(2):23-30.
Chicago Güzel, Gökalp, Özgür Altınbaş, Erhan Hafız, ve Haşim Ustunsoy. “The Effects of the Aetiologic and Prognostic Values in Heart Failure on Life Expectancy and the Timing of Mechanical Circulatory Support: Are We Heading for the Bionic Heart?”. Doğal Yaşam Tıbbı Dergisi 4, sy. 2 (Aralık 2022): 23-30.
EndNote Güzel G, Altınbaş Ö, Hafız E, Ustunsoy H (01 Aralık 2022) The Effects of the Aetiologic and Prognostic Values in Heart Failure on Life Expectancy and the Timing of Mechanical Circulatory Support: Are we heading for the bionic heart?. Doğal Yaşam Tıbbı Dergisi 4 2 23–30.
IEEE G. Güzel, Ö. Altınbaş, E. Hafız, ve H. Ustunsoy, “The Effects of the Aetiologic and Prognostic Values in Heart Failure on Life Expectancy and the Timing of Mechanical Circulatory Support: Are we heading for the bionic heart?”, DYT, c. 4, sy. 2, ss. 23–30, 2022.
ISNAD Güzel, Gökalp vd. “The Effects of the Aetiologic and Prognostic Values in Heart Failure on Life Expectancy and the Timing of Mechanical Circulatory Support: Are We Heading for the Bionic Heart?”. Doğal Yaşam Tıbbı Dergisi 4/2 (Aralık 2022), 23-30.
JAMA Güzel G, Altınbaş Ö, Hafız E, Ustunsoy H. The Effects of the Aetiologic and Prognostic Values in Heart Failure on Life Expectancy and the Timing of Mechanical Circulatory Support: Are we heading for the bionic heart?. DYT. 2022;4:23–30.
MLA Güzel, Gökalp vd. “The Effects of the Aetiologic and Prognostic Values in Heart Failure on Life Expectancy and the Timing of Mechanical Circulatory Support: Are We Heading for the Bionic Heart?”. Doğal Yaşam Tıbbı Dergisi, c. 4, sy. 2, 2022, ss. 23-30.
Vancouver Güzel G, Altınbaş Ö, Hafız E, Ustunsoy H. The Effects of the Aetiologic and Prognostic Values in Heart Failure on Life Expectancy and the Timing of Mechanical Circulatory Support: Are we heading for the bionic heart?. DYT. 2022;4(2):23-30.