METHODS: We reviewed 50 consecutive dilated cardiomyopathy patients implanted with HeartMate II at our institute between April 2013 and December 2018 who were treated with optimal medical therapy during left ventricular assist device support. Patients were stratified by improvement of the left ventricular ejection fraction at 6 months after implantation: ≥ 10% increase (Gr ≥ 10%), 5-10% (Gr 5-10%), and ≤ 5% (Gr ≤ 5%). T cells and macrophages were evaluated in the apical myocardium after left ventricular assist device implantation.
RESULTS: During left ventricular assist device support, 12 patients underwent heart transplantation and 2 patients died. Four patients with Gr ≤ 5% were readmitted because of congestive heart failure, but none with Gr ≥ 10%. Macrophages and T cells in the left ventricular myocardium with Gr ≥ 10% were significantly more present compared to those in other groups.
CONCLUSIONS: The distribution of immunocompetent cells in the left ventricular myocardium might predict myocardial viability of this pathology after implantation.
方法:我们回顾了2013年4月至2018年12月在我们研究所植入HeartMateII的50例连续扩张型心肌病患者,这些患者在左心室辅助装置支持期间接受了最佳药物治疗。植入后6个月左心室射血分数的改善对患者进行分层:增加≥10%(Gr≥10%),5-10%(Gr5-10%),且≤5%(Gr≤5%)。左心室辅助装置植入后,在心尖心肌中评估T细胞和巨噬细胞。
结果:在左心室辅助装置支持期间,12例患者行心脏移植,2例患者死亡。4例Gr≤5%的患者因充血性心力衰竭再次入院,但没有一个Gr≥10%。与其他组相比,Gr≥10%的左心室心肌中的巨噬细胞和T细胞明显更多。
结论:左心室心肌中免疫活性细胞的分布可能预测植入后该病理的心肌活力。