Ngokuguga kwenani labantu kanye nokuthuthuka kokuxilongwa nokwelashwa kwezifo zenhliziyo, ukwehluleka kwenhliziyo okungapheli (ukwehluleka kwenhliziyo) ukuphela kwesifo senhliziyo esanda kukhula kanye nokusabalala.Inani labantu baseShayina leziguli ezinesifo senhliziyo ezingamahlalakhona ngo-2021 cishe izigidi eziyi-13.7, kulindeleke ukuthi lifinyelele ezigidini eziyi-16.14 ngonyaka ka-2030, ukufa kwenhliziyo kuzofinyelela ezigidini eziyi-1.934.
Ukuhluleka kwenhliziyo kanye ne-atrial fibrillation (AF) kuvame ukuhlala ndawonye.Kufika ku-50% weziguli ezintsha zokuhluleka kwenhliziyo zine-atrial fibrillation;Phakathi kwezimo ezintsha ze-atrial fibrillation, cishe ingxenye eyodwa kwezintathu inokwehluleka kwenhliziyo.Kunzima ukuhlukanisa phakathi kwembangela kanye nomphumela wokuhluleka kwenhliziyo kanye ne-atrial fibrillation, kodwa ezigulini ezinesifo senhliziyo kanye ne-atrial fibrillation, ucwaningo oluningana luye lwabonisa ukuthi ukukhishwa kwe-catheter kunciphisa kakhulu ingozi yokufa yonke imbangela kanye nokuhluleka kwenhliziyo ukufunda.Kodwa-ke, azikho kulezi zifundo ezihlanganisa iziguli ezine-fibrillation yokuphela kwesiteji esihlangene ne-fibrillation ye-atrial, futhi imihlahlandlela yakamuva kakhulu ekuhlulekeni kwenhliziyo kanye nokukhishwa kwe-ablation ihlanganisa ukukhishwa njengesiphakamiso se-Class II ezigulini ezinanoma yiluphi uhlobo lwe-fibrillation ye-atrial kanye nengxenye encishisiwe ye-ejection, kuyilapho. I-amiodarone iyisincomo Sekilasi I
Ucwaningo lwe-CASTLE-AF, olwanyatheliswa ngo-2018, lwabonisa ukuthi ezigulini ezine-atrial fibrillation ehlanganiswe nokuhluleka kwenhliziyo, ukukhishwa kwe-catheter kunciphisa kakhulu ingozi yokufa okubangelwa yizo zonke izinkinga kanye nokuhluleka kwenhliziyo ukufunda uma kuqhathaniswa nemithi.Ngaphezu kwalokho, ucwaningo oluningi luye lwaqinisekisa izinzuzo zokukhishwa kwe-catheter ekuthuthukiseni izimpawu, ukuguqula ukuguqulwa kwenhliziyo, nokunciphisa umthwalo we-atrial fibrillation.Kodwa-ke, iziguli ezine-fibrillation ye-atrial kuhlangene nokuhluleka kwenhliziyo kwesigaba sokuphela ngokuvamile azifakwa kubantu bocwaningo.Kulezi ziguli, ukudluliselwa okufika ngesikhathi kokufakelwa kwenhliziyo noma ukufakwa kwe-left ventricular assist device (LVAD) kusebenza kahle, kodwa kusenokuntuleka kobufakazi bezokwelapha obusekelwe ebufakazini bokuthi ukukhishwa kwe-catheter kunganciphisa ukufa futhi kubambezele ukufakwa kwe-LVAD ngenkathi ulinde inhliziyo. ukufakelwa kabusha.
Ucwaningo lwe-CASTLE-HTx bekuyisikhungo esisodwa, ilebula evulekile, isilingo esilawulwa ngokungahleliwe esiqaliswe umphenyi sokusebenza okuphakeme.Ucwaningo lwenziwa e-Herz- und Diabeteszentrum Nordrhein-Westfale, isikhungo sokudlulisela ukufakelwa kwenhliziyo eJalimane esenza ukufakelwa kabusha okungaba ngu-80 ngonyaka.Ingqikithi yeziguli ze-194 ezinokuhluleka kwenhliziyo kwesigaba sokuphela ezinezimpawu ze-atrial fibrillation ezahlolwa ukuthi zifaneleka yini ukufakelwa inhliziyo noma ukufakelwa kwe-LVAD zabhaliswa kusukela ngoNovemba 2020 kuya kuMeyi 2022. Zonke iziguli zazinamadivayisi enhliziyo afakelwayo anokuqapha okuqhubekayo kwesigqi senhliziyo.Zonke iziguli zazingahleliwe ngesilinganiso esingu-1:1 ukuze zithole ukukhishwa kwe-catheter kanye nemithi eqondiswe isiqondiso noma zithole imithi yodwa.Isiphetho esiyinhloko sasiyinhlanganisela yazo zonke izizathu zokufa, ukufakwa kwe-LVAD, noma ukufakelwa kwenhliziyo okuphuthumayo.Iziphetho zesibili zihlanganisa ukufa kwembangela yonke, ukufakwa kwe-LVAD, ukufakelwa kwenhliziyo okuphuthumayo, ukufa kwenhliziyo, kanye nezinguquko engxenyeni ye-left ventricular ejection (LVEF) kanye nomthwalo we-atrial fibrillation ku-6 nezinyanga ze-12 zokulandelela.
NgoMeyi 2023 (unyaka owodwa ngemva kokubhaliswa), iKomidi Lokuqapha Idatha Nokuphepha lathola ekuhlaziyeni kwesikhashana ukuthi izehlakalo eziyinhloko zokuphela phakathi kwamaqembu amabili zazihluke kakhulu futhi zinkulu kunalokho okwakulindelekile, ukuthi iqembu lokukhishwa kwe-catheter lalisebenza kangcono futhi lihambisana umthetho we-Haybittle-Peto, futhi wancoma ukuthi kuqedwe ngokushesha uhlobo lwezidakamizwa olushiwo ocwaningweni.Abaphenyi bamukele isincomo sekomiti sokushintsha umthetho olandelwayo wocwaningo ukuze kuncishiswe idatha yokulandelela yesiphetho esiyinhloko ngoMeyi 15, 2023.
Ukufakelwa kwenhliziyo kanye nokufakwa kwe-LVAD kubalulekile ukuze kuthuthukiswe ukubikezelwa kweziguli ezinokuhluleka kwenhliziyo ekupheleni okuhlangene ne-fibrillation ye-atrial, noma kunjalo, izinsiza ezilinganiselwe zomnikeli nezinye izici zinciphisa ukusetshenziswa kwazo okubanzi ngezinga elithile.Ngenkathi silinde ukufakelwa kwenhliziyo kanye ne-LVAD, yini enye esingayenza ukunciphisa ukuqhubeka kwesifo ngaphambi kokuba kungene ukufa?Ucwaningo lwe-CASTLE-HTx ngokungangabazeki lubaluleke kakhulu.Akugcini nje ngokuqinisekisa izinzuzo zokukhishwa kwe-catheter ezigulini ezine-AF ekhethekile, kodwa futhi inikeza indlela ethembisayo yokufinyeleleka okuphezulu ezigulini ezinokwehluleka kwenhliziyo kwesigaba sokuphela okuyinkimbinkimbi ne-AF.
Isikhathi sokuthumela: Sep-02-2023