Sun Mingwei,Yang Lijun,Lin Ru.Recent advances of mechanical circulation treatment for end-stage idiopathic cardiomyopathy in children[J].Journal of Clinical Pediatric Surgery,2023,22(05):436-442.[doi:10.3760/cma.j.cn101785-202205011-007]
儿童特发性心肌病终末期机械循环治疗进展
- Title:
- Recent advances of mechanical circulation treatment for end-stage idiopathic cardiomyopathy in children
- Keywords:
- Cardiomyopathy; Dilated; Heart Failure; Blood Circulation; Surgical Procedures; Operative; Child
- 摘要:
- 儿童特发性心肌病(idiopathic cardiomyopathy,ICM)是一种罕见病,终末期表现为心泵功能衰竭,多数患儿预后不佳。目前对于儿童ICM的终末期管理主要包括以改善心力衰竭为目的的药物治疗和心脏移植两个方面。部分患儿因供心短缺或不符合移植条件而死亡。机械循环支持可改善部分终末期ICM患儿预后,但尚未在国内儿童ICM患者中推广应用。本文以目前国内外儿童ICM及儿童心力衰竭诊治指南为参考,对特发性心肌病不同临床表型终末期血流动力学特点进行分析,结合近年机械循环支持研究进展,对儿童ICM终末期机械循环治疗的相关内容进行综述,为ICM的治疗提供新思路。
- Abstract:
- Idiopathic cardiomyopathy (ICM) is a rare pediatric disease with a poor prognosis.Current end-stage management of ICM is composed mostly of routine correcting heart failure (HF) and heart transplantation (HT).Some individuals die from a shortage of donor heart or non-suitability for HT.Mechanical circulation supports might improve the prognosis of end-stage patients.However,their applications have not been implemented for ICM children in China.Based upon current management guidelines for HF children,recent research advances of mechanical circulation support were summarized for optimal end-stage treatments of ICM children.
参考文献/References:
[1] Rupp S,Apitz C,Tholen L,et al.Upgraded heart failure therapy leads to an improved outcome of dilated cardiomyopathy in infants and toddlers[J].Cardiol Young,2015,25(7):1300-1305.DOI:10.1017/S1047951114002406.
[2] 钱明阳,洪钿.儿童心力衰竭的诊断与治疗进展[J].中华实用儿科临床杂志,2020,35(1):14-18.DOI:10.3760/cma.j.issn.2095-428X.2020.01.005. Qian MY,Hong D.Recent advances in diagnosing and treating heart failure in children[J].Chin J Appl Clin Pediatr,2020,35(1):14-18.DOI:10.3760/cma.j.issn.2095-428X.2020.01.005.
[3] Malaisrie SC,Pelletier MP,Yun JJ,et al.Pneumatic paracorporeal ventricular assist device in infants and children:initial Stanford experience[J].J Heart Lung Transplant,2008,27(2):173-177.DOI:10.1016/j.healun.2007.11.567.
[4] 郭潇.儿童扩张型心肌病的病因及预后[J].中国循环杂志,2013,28(5):396-398.DOI:10.3969/j.issn.1000-3614.2013.05.022. Guo X.Etiologies and prognoses of dilated cardiomyopathy in children[J].Chin Circ J,2013,28(5):396-398.DOI:10.3969/j.issn.1000-3614.2013.05.022.
[5] Galiè N,Humbert M,Vachiery JL,et al.2015 ESC/ERS guidelines for the diagnosis and treatment of pulmonary hypertension:the joint task force for the diagnosis and treatment of pulmonary hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS):endorsed by:Association for European Paediatric and Congenital Cardiology (AEPC),International Society for Heart and Lung Transplantation (ISHLT)[J].Eur Heart J,2016,37(1):67-119.DOI:10.1093/eurheartj/ehv317.
[6] 中华医学会儿科学分会心血管学组儿童心肌病精准诊治协作组,《中国实用儿科杂志》编辑委员会.中国儿童肥厚型心肌病诊断的专家共识[J].中国实用儿科杂志,2019,34(5):329-334.DOI:10.19538/j.ek2019050601. Collaborative Group for Accurate Diagnosis & Treatment of Children’s Cardiomyopathy,Group of Cardiology,Branch of Pediatrics,Chinese Medical Association; Editorial Board of Chinese Journal of Practical Pediatrics:Expert Consensus on Diagnosing Hypertrophic Cardiomyopathy in Chinese Children[J].Chin J Pract Pediatr,2019,34(5):329-334.DOI:10.19538/j.ek2019050601.
[7] 傅立军,张浩.AHA儿童心肌病的分类和诊断科学声明解读[J].中国循环杂志,2019,34(S1):49-53.DOI:10.3969/j.issn.1000-3614.2019.增刊.011. Fu LJ,Zhang H.Interpretation of scientific statements on classification and diagnosis of cardiomyopathy in AHA children[J].Chin Circ J,2019,34(S1):49-53.DOI:10.3969/j.issn.1000-3614.2019.增刊.011.
[8] 颜超,罗蓉,张红梅,等.左室心肌致密化不全患者的临床特点及预后影响因素分析[J].临床心血管病杂志,2018,34(9):903-908.DOI:10.13201/j.issn.1001-1439.2018.09.015. Yan C,Luo R,Zhang HM,et al.Clinical characteristics and prognoses of patients with left ventricular non-compaction[J].J Clin Cardiol,2018,34(9):903-908.DOI:10.13201/j.issn.1001-1439.2018.09.015.
[9] 黄小芳,张淑芳,许强宏,等.致心律失常性右心室心肌病进展[J].中华急诊医学杂志,2018,27(11):1307-1310.DOI:10.3760/cma.j.issn.1671-0282.2018.11.028. Huang XF,Zhang SF,Xu QH,et al.Recent advances in arrhythmogenic right ventricular cardiomyopathy[J].Chin J Emerg Med,2018,27(11):1307-1310.DOI:10.3760/cma.j.issn.1671-0282.2018.11.028.
[10] Yarlagadda VV,Maeda K,Zhang YL,et al.Temporary circulatory support in U.S.children awaiting heart transplantation[J].J Am Coll Cardiol,2017,70(18):2250-2260.DOI:10.1016/j.jacc.2017.08.072.
[11] 洪小杨,封志纯.稳妥推进体外膜肺氧合在儿童重症医学的应用[J].中华儿科杂志,2015,53(8):564-565.DOI:10.3760/cma.j.issn.0578-1310.2015.08.003. Hong XY,Feng ZC.Steady promotion of extracorporeal membrane oxygenation in pediatric critical medicine[J].Chin J Pediatr,2015,53(8):564-565.DOI:10.3760/cma.j.issn.0578-1310.2015.08.003.
[12] 刘长智,周柱江,朱瑞秋,等.心源性休克应用体外膜肺氧合期间并发左室膨胀的观察研究[J].中华急诊医学杂志,2017,26(1):113-115.DOI:10.3760/cma.j.issn.1671-0282.2017.01.023. Liu CZ,Zhou ZJ,Zhu RQ,et al.Observations of left ventricular dilation during extracorporeal membrane oxygenation in patients with cardiogenic shock[J].Chin J Emerg Med,2017,26(1):113-115.DOI:10.3760/cma.j.issn.1671-0282.2017.01.023.
[13] Dipchand AI,Mahle WT,Tresler M,et al.Extracorporeal membrane oxygenation as a bridge to pediatric heart transplantation:effect on post-listing and post-transplantation outcomes[J].Circ Heart Fail,2015,8(5):960-969.DOI:10.1161/CIRCHEARTFAILURE.114.001553.
[14] 孟凡,杨明,胡仁杰.儿童心室辅助装置发展现状[J].中国医疗设备,2016,31(1):16-20.DOI:10.3969/j.issn.1674-1633.2016.01.004. Meng F,Yang M,Hu RJ.Development status of ventricular assist devices in children[J].Chin Med Dev,2016,31(1):16-20.DOI:10.3969/j.issn.1674-1633.2016.01.004.
[15] Burkhoff D,Cohen H,Brunckhorst C,et al.A randomized multicenter clinical study to evaluate the safety and efficacy of the TandemHeart percutaneous ventricular assist device versus conventional therapy with intraaortic balloon pumping for treatment of cardiogenic shock[J].Am Heart J,2006,152(3):469.e1-469.e8.DOI:10.1016/j.ahj.2006.05.031.
[16] Kulat BT,Russell HM,Sarwark AE,et al.Modified TandemHeart ventricular assist device for infant and pediatric circulatory support[J].Ann Thorac Surg,2014,98(4):1437-1441.DOI:10.1016/j.athoracsur.2014.05.093.
[17] Parekh D,Jeewa A,Tume SC,et al.Percutaneous mechanical circulatory support using Impella devices for decompensated cardiogenic shock:a pediatric heart center experience[J].ASAIO J,2018,64(1):98-104.DOI:10.1097/MAT.0000000000000581.
[18] Dimas VV,Morray BH,Kim DW,et al.A multicenter study of the Impella device for mechanical support of the systemic circulation in pediatric and adolescent patients[J].Catheter Cardiovasc Interv,2017,90(1):124-129.DOI:10.1002/ccd.26973.
[19] Chen K,Williams S,Chan AKC,et al.Thrombosis and embolism in pediatric cardiomyopathy[J].Blood Coagul Fibrinolysis,2013,24(3):221-230.DOI:10.1097/MBC.0b013e32835bfd85.
[20] Singh M,Parameshwar J,Lewis C,et al.Biventricular assist device use in non-dilated hypertrophic cardiomyopathy[J].Eur J Cardiothorac Surg,2015,47(5):929-930.DOI:10.1093/ejcts/ezu233.
[21] Hetzer R,Kaufmann F,Delmo Walter EM.Paediatric mechanical circulatory support with Berlin Heart EXCOR:development and outcome of a 23-year experience[J].Eur J Cardiothorac Surg,2016,50(2):203-210.DOI:10.1093/ejcts/ezw011.
[22] Su JA,Menteer J.Outcomes of Berlin Heart EXCOR? pediatric ventricular assist device support in patients with restrictive and hypertrophic cardiomyopathy[J].Pediatr Transplant,2017,21(8):e13048.DOI:10.1111/petr.13048.
[23] Miera O,Morales DLS,Thul J,et al.Improvement of survival in low-weight children on the Berlin Heart EXCOR ventricular assist device support[J].Eur J Cardiothorac Surg,2019,55(5):913-919.DOI:10.1093/ejcts/ezy394.
[24] Van Dorn CS,Aganga DO,Johnson JN.Extracorporeal membrane oxygenation,Berlin,and ventricular assist devices:a primer for the cardiologist[J].Curr Opin Cardiol,2018,33(1):87-94.DOI:10.1097/HCO.0000000000000479.
[25] Wilmot I,Lorts A,Morales D.Pediatric mechanical circulatory support[J].Korean J Thorac Cardiovasc Surg,2013,46(6):391-401.DOI:10.5090/kjtcs.2013.46.6.391.
[26] Padalino MA,Bottio T,Tarzia V,et al.HeartWare ventricular assist device as bridge to transplant in children and adolescents[J].Artif Organs,2014,38(5):418-422.DOI:10.1111/aor.12185.
[27] Mossad EB,Motta P,Rossano J,et al.Perioperative management of pediatric patients on mechanical cardiac support[J].Paediatr Anaesth,2011,21(5):585-593.DOI:10.1111/j.1460-9592.2011.03540.x.
[28] Mehra MR,Uriel N,Naka Y,et al.A fully magnetically levitated left ventricular assist device-final report[J].N Engl J Med,2019,380(17):1618-1627.DOI:10.1056/NEJMoa1900486.
[29] Netuka I,Kvasni?ka T,Kvasni?ka J,et al.Evaluation of von Willebrand factor with a fully magnetically levitated centrifugal continuous-flow left ventricular assist device in advanced heart failure[J].J Heart Lung Transplant,2016,35(7):860-867.DOI:10.1016/j.healun.2016.05.019.
[30] Geisen U,Brehm K,Trummer G,et al.Platelet secretion defects and acquired von Willebrand syndrome in patients with ventricular assist devices[J].J Am Heart Assoc,2018,7(2):e006519.DOI:10.1161/JAHA.117.006519.
[31] Baldwin JT,Borovetz HS,Duncan BW,et al.The national heart,lung,and blood institute pediatric circulatory support program:a summary of the 5-year experience[J].Circulation,2011,123(11):1233-1240.DOI:10.1161/CIRCULATIONAHA.110.978023.
[32] Baldwin JT,Adachi I,Teal J,et al.Closing in on the PumpKIN trial of the Jarvik 2015 ventricular assist device[J].Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu,2017,20:9-15.DOI:10.1053/j.pcsu.2016.09.003.
[33] Adachi I.Current status and future perspectives of the PumpKIN trial[J].Transl Pediatr,2018,7(2):162-168.DOI:10.21037/tp.2018.02.04.
[34] Zareba W,Klein H,Cygankiewicz I,et al.Effectiveness of cardiac resynchronization therapy by QRS morphology in the multicenter automatic defibrillator implantation trial-cardiac resynchronization therapy (MADIT-CRT)[J].Circulation,2011,123(10):1061-1072.DOI:10.1161/CIRCULATIONAHA.110.960898.
[35] Bardy GH,Lee KL,Mark DB,et al.Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure[J].N Engl J Med,2005,352(3):225-237.DOI:10.1056/NEJMoa043399.
[36] Ponikowski P,Voors AA,Anker SD,et al.2016 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure:the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC).Developed with the special contribution of the Heart Failure Association (HFA) of the ESC[J].Eur Heart J,2016,37(27):2129-2200.DOI:10.1093/eurheartj/ehw128.
[37] K?ber L,Thune JJ,Nielsen JC,et al.Defibrillator implantation in patients with nonischemic systolic heart failure[J].N Engl J Med,2016,375(13):1221-1230.DOI:10.1056/NEJMoa1608029.
[38] Elming MB,Nielsen JC,Haarbo J,et al.Age and outcomes of primary prevention implantable cardioverter-defibrillators in patients with nonischemic systolic heart failure[J].Circulation,2017,136(19):1772-1780.DOI:10.1161/CIRCULATIONAHA.117.028829.
[39] Bristow MR,Saxon LA,Feldman AM,et al.Lessons learned and insights gained in the design,analysis,and outcomes of the COMPANION trial[J].JACC Heart Fail,2016,4(7):521-535.DOI:10.1016/j.jchf.2016.02.019.
[40] Janousek J,Gebauer RA,Abdul-Khaliq H,et al.Cardiac resynchronisation therapy in paediatric and congenital heart disease:differential effects in various anatomical and functional substrates[J].Heart,2008,95(14):1165-1171.DOI:10.1136/hrt.2008.160465.
[41] Schiller O,Dham N,Greene EA,et al.Pediatric dilated cardiomyopathy patients do not meet traditional cardiac resynchronization criteria[J].J Cardiovasc Electrophysiol,2015,26(8):885-889.DOI:10.1111/jce.12690.
备注/Memo
收稿日期:2022-5-3。
基金项目:国家中心自主设计项目(T21D0001)
通讯作者:林茹,Email:linru.008@zju.edu.cn