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多巴酚丁胺间断静脉注射联合胺碘酮口服疗法逆转特发性扩张型心肌病致终末期心衰患者的左心室重构

世界核心医学期刊文摘（心脏病学分册） 2006年第8期2卷 48-49页

作者： nanas J. n. Tsagalou E. P. nanas.s. n. 李少君(译) 孙凯(校) Makedon.as 24 104 33 Athens Greece 不详

Backgroun.: The aim of this study was to evaluate the lon.term effect of combin.d in.ermitten. dobutamin. in.usion.(IDI) an. oral amiodaron. on.reverse left ven.ricular(LV) remodelin. an. hemodyn.mics of patien.s with idiopathic dilated cardiomyopathy(IDC) an. en.-stage con.estive heart failure(CHF). Methods: This n.n.ran.omized, prospective, clin.cal trial in.luded sixteen.con.ecutive patien.s sufferin. from dyspn.a for a mean.of 76± 43 mon.hs, who presen.ed with acute cardiac decompen.ation.an. were wean.d from dobutamin. therapy after an.in.tial 72-h in.usion. They were then.placed on.a regimen.of oral amiodaron., 400 mg/day an. weekly IDI, 10 μ g/kg/min. for 8 h. The lon.-term clin.cal outcomes an. the effects of treatmen. on.reverse LV remodelin.(echocardiographic parameters) an. hemodyn.mics were evaluated at 3, 6, an. 12 mon.hs of follow up. Results: A sign.fican. degree of reverse LV remodelin., hemodyn.mic improvemen.s, an. survivals >1.5 years were observed in.9 of the 16 patien.s(56% ). In.addition. 5 patien.s(31% of en.ire cohort) were wean.d from IDI after a mean.of 61± 41 weeks, an. 4 remain.d clin.cally stable for 116± 66 weeks thereafter. At 12 mon.hs of follow-up, LV en.-diastolic an. en.-systolic volume in.ices had decreased from 231± 91 to 206± 80 ml/m2(P=0.002) an. from 137± 65 to 110± 50 ml/m2(P=0.003), respectively, right atrial pressure from 16± 6 to 5.6± 4 mm Hg,(P=0.031), an. pulmon.ry capillary wedge pressure from 29± 4 to 16± 5.4 mm Hg, P=0.000, while LV ejection.fraction.had in.reased from 22± 6% to 27.3± 8% (P=0.006). Con.lusion.: In.en.-stage CHF due to IDC, lon.-term treatmen. with IDI an. oral amiodaron. caused reverse LV remodelin., an. allowed perman.n. an. successful wean.n. from IDI in.1 / 4 of patien.s.

关键词：终末期充血性心力衰竭特发性扩张型心肌病多巴酚丁胺左心室重构口服胺碘酮心衰患者静脉注射重构逆转口服疗法联合

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son.graphic muscle mass assessmen. in.patien.s after cardiac surgery

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World Journ.l of Cardiology 2020年第7期12卷 351-361页

作者： stavros Dimopoulos Vasiliki Raidou Dimitrios Elaiopoulos Fotein. Chatzivasiloglou Despoin. Markan.on.ki Efterpi Lyberopoulou Ioan.is Vasileiadis Katerin. Marathias serafeim nanas An.reas Karabin.s Departmen. of Cardiac surgery ICU Onassis Cardiac Surgery CenterAthens 17674Greece Clin.cal Ergospirometry Exercise and Rehabilitation LaboratoryNational and Kapodistrian University of AthensAthens 10676Greece

BACKGROUn. Patien.s un.ergoin. cardiac surgery particularly those with comorbidities an. frailty,experien.e frequen.ly higher rates of post-operative morbidity,mortality an. prolon.ed hospital len.th of *** mass wastin. seems to play importan. role in.prolon.ed mechan.cal ven.ilation.MV)an. con.equen.ly in.in.en.ive care un.t(ICU)an. hospital *** To in.estigate the clin.cal value of skeletal muscle mass assessed by ultrasoun. early after cardiac surgery in.terms of duration.of MV an. ICU len.th of *** In.this observation.l study,we en.olled con.ecutively all patien.s,followin. their admission.in.the Cardiac surgery ICU within.24 h of cardiac *** ultrasoun. scan.,for the assessmen. of quadriceps muscle thickn.ss,were performed at baselin. an. every 48 h for seven.days or un.il ICU *** stren.th was also evaluated in.parallel,usin. the Medical Research Coun.il(MRC)*** Of the total 221 patien.s en.olled,ultrasoun. scan. an. muscle stren.th assessmen. were fin.lly performed in.165 patien.s(patien.s excluded if ICU stayscle thickn.ss of rectus femoris(RF),was slightly decreased by 2.2%[(95%con.iden.e in.erval(CI):-0.21 to 0.15),n.9;P=0.729]an. the combin.d muscle thickn.ss of the vastus in.ermedius(VI)an. RF decreased by 3.5%[(95%CI:-0.4 to 0.22),n.9;P=0.530].Patien.s whose combin.d VI an. RF muscle thickn.ss was below the recorded median.values(2.5 cm)on.day 1(n.80),stayed lon.er in.the ICU(47±74 h vs 28±45 h,P=0.02)an. remain.d mechan.cally ven.ilated more(17±9 h vs 14±9 h,P=0.05).Moreover,patien.s with MRC score≤48 on.day 3(n.7),required prolon.ed MV support compared to patien.s with MRC score≥49(n.33),(44±14 h vs 19±9 h,P=0.006)an. had a lon.er duration.of extracorporeal circulation.was(159±91 min.vs 112±71 min.P=0.025).COn.LUsIOn.skeletal quadriceps muscle thickn.ss assessed by ultrasoun. shows a tren. to a decrease in.patien.s after cardiac surgery post-ICU admission.an. is associated with prolon.

关键词： In.en.ive care un.t-acquired weakn.ss Cardiac surgery skeletal muscle wastin. Muscle ultrasoun. Quadriceps femoris Muscle mass

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Con.in.ous in.ern.l coun.erpulsation.as a bridge to recovery in.acute an. chron.c heart failure

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World Journ.l of Tran.plan.ation 2016年第1期6卷 115-124页

作者： Christos D Kon.ogian.is Kon.tan.in.s Malliaras Chris J Kapelios Jay W Mason.John.n.nanas 3~(rd) Departmen. of Cardiology University of Athens School of Medicine Cardiology Division University of Utah

Cardiac recovery from cardiogen.c shock(Cs) an. en.-stage chron.c heart failure(HF) remain. an.ften.in.urmoun.able therapeutic challen.e. The coun.erpulsation.techn.que exerts n.merous ben.ficial effects on.systemic hemodyn.mics an. left ven.ricular mechan.en.rgetics, ren.erin. it attractive for promotin. myocardial recovery in.both acute an. chron.c HF. Although a recen. clin.cal trial has question.d the clin.cal effectiven.ss of short-term hemodyn.mic support with in.ra-aortic balloon.pump(IABP, the main.represen.ative of the coun.erpulsation.techn.que) in.Cs complicatin. myocardial in.arction. the issue remain. open.to further in.estigation. Moreover, prelimin.ry data suggest that lon.-term IABP support in.patien.s with en.-stage HF is safe an. may mediate recovery of left- or/an. right-sided cardiac fun.tion. facilitatin. lon.-term wean.n. from mechan.cal support or en.blin. the application.of other perman.n., life-savin. solution.. The poten.ial of lon.-term coun.erpulsation.could possibly be en.an.ed by implemen.ation.of n.vel, fully implan.able coun.erpulsation.devices.

关键词： Coun.erpulsation Recovery In.ra-aortic balloon pump Heart failure Cardiac remodelin. Reverse remodelin.

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多巴酚丁胺间断注射联合胺碘酮口服疗法对远期生存率的有利作用在特发性扩张型心肌病患者中大于缺血性心脏疾病患者中

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世界核心医学期刊文摘（心脏病学分册） 2006年第8期2卷 49-49页

作者： Tsagalou E.P. An.stasiou-n.n. M.I. Terrovitis J.V. J.n. nanas 李少君 Un.versity of Athen. school of Medicin. Department of Clinical Therapeutics Alexandra Hospital Makedonias 24 104 33 Athens Greece

Backgroun.: In.ermitten. dobutamin. in.usion.(IDI) combin.d with oral amiodaron. improve the survival of patien.s with en.-stage con.estive heart failure(CHF). The purpose of the presen. study was to evaluate whether the respon.e to lon.term treatmen. with IDI + amiodaron. is differen. in.patien.s with ischemic heart disease(IHD) versus idiopathic dilated cardiomyopathy(IDC).Methods: The prospective study population.con.isted of 21 patien.s with IHD(the IHD Group) an. 16 patien.s with IDC(the IDC Group) who presen.ed with decompen.ated CHF despite optimal medical therapy, an. were successfully wean.d from an.in.tial 72-h in.usion.of dobutamin.. They were placed on.a regimen.of oral amiodaron., 400 mg/day an. weekly IDI, 10 μ g/kg/min. for 8 h. Results: There were n. differen.es in.baselin. clin.cal an. hemodyn.mic characteristics between.the 2 groups. The probability of 2-year survival was 44% in.the IDC Group versus 5% in.the IHD Group(lon.-ran., P=0.004). Patien.s with IDC had a 77% relative risk reduction.in.death from all causes compared to patien.s with IHD(odd ratio 0.27, 95% con.iden.e in.erval 0.13 to 0.70, P=0.007). In.con.rast, n. un.erlyin. disease-related differen.e in.outcomes was observed in.a retrospectively an.lyzed historical Comparison.Group of 29 patien.s with en. stage CHF treated by stan.ard methods. Con.lusion.: Patien.s with en. stage CHF due to IDC derived a greater survival ben.fit from IDI an. oral amiodaron. than.patien.s with IHD.

关键词：特发性扩张型心肌病缺血性心脏疾病多巴酚丁胺口服胺碘酮疾病患者静脉注射远期生存率口服疗法扩张型心肌病患者终末期充血性心力衰竭

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