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Percutaneous Ventricular Restoration Therapy Using the Parachute Device in Chinese Patients with Ischemic Heart Failure: Three-Month Primary End-point Results of PARACHUTE China Study

摘要Background:The primary cause of ischemic heart failure (HF) is myocardial infarction (MI) resulting in left ventricle (LV) wall motion abnormality secondary to ventricular remodeling.A prospective,nonrandomized study conducted in China was designed to assess safety and efficacy of the percutaneous ventricular restoration therapy using Parachute device (CardioKinetix,Inc.,CA,USA) in ischemic HF patients as a result of LV remodeling after anterior wall MI.Methods:Thirty-one patients with New York Heart Association (NYHA) Class Ⅱ,Ⅲ ischemic HF,ejection fraction between 15% and 40%,and dilated akinetic or dyskinetic anterior-apical wall without the need to be revascularized were enrolled from seven sites in China from October to December 2014.The Parachute device was implanted through femoral artery.All patients received low-dose aspirin and anticoagulation with warfarin for at least 12 months postdevice implantation.The primary end-point was the assessment of efficacy as measured by the reduction in LV end-systolic volume index (LVESVI) against baseline LVESVI at 3 months postdevice implantation,determined by the echocardiography and measured by echocardiography core laboratory.Quality of life was assessed using EQ-5D and visual analog scale (VAS).For quantitative data comparison,paired t-test (normality data) and signed-rank test (abnormality data) were used;application of signed-rank test was for the ranked data comparison.Results:A change in LVESVI as measured by echocardiography from the preimplant baseline to 3-month postdevice implantation revealed a statistically significant reduction from 77.5 ± 20.0 ml/m2 to 53.1 ± 17.0 ml/m2 (P < 0.0001).The trial met its primary end-point.Of the 31 patients,the procedural success was 96.8%.Overall,NYHA HF class assessment results showed an improvement of more than halfa class at 3 months (P < 0.001).Quality of life assessed by the VAS value increased 11.5 points (P < 0.01),demonstrating improvement at 3 months.Conclusion:The favorable outcomes observed in the high-risk patients provide reassuring safety and efficacy data to support adoption of this technology as a therapeutic option for ischemic HF patients.Trial Registration:ClinicalTrials.gov,NCT02240940;https://clinicaltrials.gov/ct2/show/NCT02240940.

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作者单位 Department of Cardiology, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing 100037, China [1] Department of Cardiology, Peking University First Hospital, Beijing 100034, China [2] Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University, Shanghai 200072, China [3] Department of Cardiology, The Second Affiliated Hospital of Zhejiang University, Hangzhou, Zhejiang 310009, China [4] Department of Cardiology, The General Hospital of Shenyang Military Region, Shenyang, Liaoning 110000, China [5] Department of Cardiology, Fudan University, Zhongshan Hospital, Shanghai 200032, China [6] Department of Cardiology, School of Medicine, Shanghai Jiaotong University, Ruijin Hospital, Shanghai 200025, China [7]
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DOI 10.4103/0366-6999.189048
发布时间 2016-10-09(万方平台首次上网日期,不代表论文的发表时间)
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中华医学杂志(英文版)

中华医学杂志(英文版)

2016年129卷17期

2058-2062页

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