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781.
Lay-Yee Roy Matthews Timothy Moffitt Terrie Poulton Richie Caspi Avshalom Milne Barry 《Social psychiatry and psychiatric epidemiology》2023,58(3):373-382
Social Psychiatry and Psychiatric Epidemiology - Social isolation has been shown to have negative effects on mental health outcomes though little is known about trajectories across the life course.... 相似文献
782.
Domenico D'Amario David Meerkin Attilio Restivo Hüseyin Ince Horst Sievert Andrea Wiese Ulrich Schaefer Carlo Trani Antoni Bayes-Genis Francisco Leyva Zachary I. Whinnett Carlo Di Mario Michael Jonas Habib Manhal Ignacio J. Amat-Santos Maria Del Trigo Tuvia Ben Gal Binyamin Ben Avraham Tal Hasin Sebastian Feickert Giuseppe D'Ancona Omar Abdul-Jawad Altisent Oran Koren Oren Caspi William T. Abraham Filippo Crea Stefan D. Anker Ran Kornowski Leor Perl the VECTOR-HF Trial Investigators 《European journal of heart failure》2023,25(6):902-911
Aims
In heart failure (HF), implantable haemodynamic monitoring devices have been shown to optimize therapy, anticipating clinical decompensation and preventing hospitalization. Direct left-sided haemodynamic sensors offer theoretical benefits beyond pulmonary artery pressure monitoring systems. We evaluated the safety, usability, and performance of a novel left atrial pressure (LAP) monitoring system in HF patients.Methods and results
The VECTOR-HF study (NCT03775161) was a first-in-human, prospective, multicentre, single-arm, clinical trial enrolling 30 patients with HF. The device consisted of an interatrial positioned leadless sensor, able to transmit LAP data wirelessly. After 3 months, a right heart catheterization was performed to correlate mean pulmonary capillary wedge pressure (PCWP) with simultaneous mean LAP obtained from the device. Remote LAP measurements were then used to guide patient management. The miniaturized device was successfully implanted in all 30 patients, without acute major adverse cardiac and neurological events (MACNE). At 3 months, freedom from short-term MACNE was 97%. Agreement between sensor-calculated LAP and PCWP was consistent, with a mean difference of −0.22 ± 4.92 mmHg, the correlation coefficient and the Lin's concordance correlation coefficient values were equal to 0.79 (p < 0.0001) and 0.776 (95% confidence interval 0.582–0.886), respectively. Preliminary experience with V-LAP-based HF management was associated with significant improvements in New York Heart Association (NYHA) functional class (32% of patients reached NYHA class II at 6 months, p < 0.005; 60% of patients at 12 months, p < 0.005) and 6-min walk test distance (from 244.59 ± 119.59 m at baseline to 311.78 ± 129.88 m after 6 months, p < 0.05, and 343.95 ± 146.15 m after 12 months, p < 0.05).Conclusion
The V-LAP™ monitoring system proved to be generally safe and provided a good correlation with invasive PCWP. Initial evidence also suggests possible improvement in HF clinical symptoms. 相似文献783.