心室辅助装置患者的肥胖、挑战和减肥策略。

IF 10.3 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Heart failure Pub Date : 2024-10-01 DOI:10.1016/j.jchf.2024.04.006

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引用次数: 0

摘要

对于晚期心力衰竭的成人患者来说，II/III 级肥胖（体重指数≥35 kg/m2）是一项重大挑战，在许多中心甚至被视为心脏移植（HT）的禁忌症。因此，人们对预防和治疗肥胖症以帮助晚期心衰患者成为心脏移植候选者的兴趣与日俱增。在所有减重策略中，减肥手术（BSx）的减重效果最好，并已显示出其价值，它能使部分患有左心室辅助装置（LVAD）和肥胖症的患者减掉足够的体重，从而获得心脏移植的机会。然而，在 LVAD 患者中，BSx 和抗肥胖药物都需要谨慎使用。在这篇综述中，作者从一般和 HT 候选者的角度描述并解释了已发表的有关肥胖和减肥策略对 LVAD 患者影响的报告。作者还概述了接受 BSx 手术的 LVAD 患者的心路历程，并回顾了围手术期方案的主要方面。

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Obesity, Challenges, and Weight-Loss Strategies for Patients With Ventricular Assist Devices

For adults with advanced heart failure, class II/III obesity (body mass index ≥35 kg/m²) represents major challenges, and it is even considered a contraindication for heart transplantation (HT) at many centers. This has led to growing interest in preventing and treating obesity to help patients with advanced heart failure become HT candidates. Among all weight-loss strategies, bariatric surgery (BSx) has the greatest weight loss efficacy and has shown value in enabling select patients with left ventricular assist devices (LVADs) and obesity to lose sufficient weight to access HT. Nevertheless, both BSx and antiobesity medications warrant caution in the LVAD population. In this review, the authors describe and interpret the available published reports on the impact of obesity and weight-loss strategies for patients with LVADs from general and HT candidacy standpoints. The authors also provide an overview of the journey of LVAD recipients who undergo BSx and review major aspects of perioperative protocols.

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来源期刊

JACC. Heart failure CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

21.20

自引率

2.30%

发文量

164

期刊介绍： JACC: Heart Failure publishes crucial findings on the pathophysiology, diagnosis, treatment, and care of heart failure patients. The goal is to enhance understanding through timely scientific communication on disease, clinical trials, outcomes, and therapeutic advances. The Journal fosters interdisciplinary connections with neuroscience, pulmonary medicine, nephrology, electrophysiology, and surgery related to heart failure. It also covers articles on pharmacogenetics, biomarkers, and metabolomics.