Imiphumela evela ekuhlaziyweni okusha kwe-protocol yedatha evela ku-ST-segment Elevation Myocardial Infarction Door-To-Unload (STEMI DTU) ucwaningo lokuhlola lubonisa ukunciphisa kakhulu usayizi we-infarct ezigulini ezithulula i-ventricular kwesokunxele (LV) nge-Impella CP. Imizuzu engu-30 ngaphambi kokungenelela kwe-coronary percutaneous (PCI) uma kuqhathaniswa neziguli ezithulula i-LV ngokushesha zilandelwa yi-PCI. Imininingwane yethulwe namuhla engqungqutheleni ka-2022 ye-Transcatheter Cardiovascular Therapeutics (TCT) e-Boston nguDkt. Navin K. Kapur, umqondisi omkhulu we-Cardiovascular Center for Research and Innovation (CVCRI) e-Tufts Medical Center kanye nomphenyi oyinhloko wesivivinyo se-pivot esingahleliwe. futhi yahlola i-STEMI DTU.
Naphezu kokuncipha okuphawulekayo kokushona okuvela ku-acute myocardial infarction (AMI) kusukela ngo-1960, kube nokwanda okufanayo kwesigameko sokuhluleka kwenhliziyo. Ukuhlaziywa kwezinga lesiguli okuhlanganisiwe okuvela ekuhlolweni okungahleliwe kwe-10 kubonise ukuthi usayizi we-infarct uhlotshaniswa kakhulu nokufa, kanye nokulaliswa esibhedlela kwenhliziyo phakathi nokulandelwa konyaka we-1 (Umfanekiso 1). Ngakho-ke, kunesidingo esibalulekile somtholampilo sokungenelela okunganciphisa ukulimala kwe-myocardial ngesikhathi se-myocardial infarction.
Braunwald et al. ngo-1971 wasikisela "ukuthi izinyathelo eziklanyelwe ukunciphisa isidingo somoya-mpilo we-myocardial futhi zithuthukise ukuchithwa kwe-coronary, uma zisetshenziswe ngokushesha, zinganciphisa ubukhulu bokugcina be-infarction (myocardial)." Kusukela ngo-1978, ucwaningo oluningi lwe-preclinical luye lwaphenya ukuthi ukunciphisa ukusetshenziswa komoyampilo we-myocardial ngokusebenzisa iphampu yokujikeleza kukhawulela ukulimala kwe-myocardial ku-IMA. Ucwaningo oluye lwahlola ukukhishwa kwemishini kusetshenziswa amadivaysi emishini luye lwabonisa ukuthi ukukhishwa ngaphambi, hhayi ngemva kokufakwa kabusha, kuyadingeka ukunciphisa ubukhulu bokuhlaselwa yinhliziyo.
izifundo zangaphambi komtholampilo zinikeze ukuqonda ezindleleni lapho ukukhishwa kwe-ventricle yesokunxele yipompo yenhliziyo ye-Impella® kunciphisa umonakalo we-myocardial.
Ngo-2015, usebenzisa imodeli yengulube evela ku-AMI, Kapur et al. kubonise ukuthi okokuqala kukhipha i-ventricle yesokunxele kusetshenziswa i-Impella CP® bese kubambezeleka ukuphinda kufakwe amanzi imizuzu engama-60. Zitholakale ziholela ekunciphiseni kokucindezeleka kwe-parietal ye-ventricular yesokunxele kanye nokucindezeleka okuphezulu kwe-parietal okuhlobene nokuphindaphinda ngokushesha. Ngempela, izinga lokunciphisa ukucindezeleka odongeni lalihlobene ngokuqondile nezinga lokunciphisa usayizi we-infarct. Ngaphezu kwalokho, ucwaningo lubonise ukuthi ukukhishwa kwe-ventricular kwesokunxele nokubambezeleka kokuphindaphinda kwasebenza uhlelo lokubonisa i-cardioprotective olwanciphisa ukufa kwamaseli futhi kwaholela ekunciphiseni kwe-43% kusayizi we-myocardial infarction.
Sole et al. ihlole imiphumela yepompo yenhliziyo ye-Impella LD® efakwe ngokuhlinzwa ekulungisweni kabusha kwe-ventricular yesokunxele futhi isebenze inyanga engu-1 ngemuva kwe-infarction kumodeli yengulube. Ukuthululwa kwe-ventricular yesokunxele, nge-Impella LD, kwaqalwa imizuzu engama-30 ngaphambi kokufakwa kabusha futhi ukusekelwa kwagcinwa kuze kube yimizuzu eyi-120 ngemuva kokufakwa kabusha. Ukukhipha i-ventricular yesokunxele kubangele umfutho ophansi we-ventricular kwesokunxele kanye nokucindezeleka odongeni kanye nomfutho we-arterial ophakeme kanye nokuphuma kwenhliziyo. Okubalulekile, ekulandeleni kwenyanga ye-1, ubukhulu be-infarct ezingulubeni ezikhishwe i-LV buncishiswe ngo-50%. Ngokusekelwe kule miphumela, abalobi baphetha ngokuthi ukunakekelwa kwangaphambi kwesikhathi nge-Impella LD ku-IMA ukulungiswa kabusha okulinganiselwe kwe-ventricle kwesokunxele, ngaleyo ndlela kuthuthukisa ukubikezela.
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