amakuru

Hamwe no gusaza kwabaturage no gutera imbere no gusuzuma no kuvura indwara zifata umutima nimiyoboro, kunanirwa k'umutima karande (kunanirwa k'umutima) nindwara yonyine yumutima nimiyoboro y'amaraso igenda yiyongera mubyorezo. Umubare w'Abashinwa barwaye indwara zidakira z'umutima mu 2021 bagera kuri miliyoni 13.7, biteganijwe ko uzagera kuri miliyoni 16.14 muri 2030, impfu z'umutima zikagera kuri miliyoni 1.934.

Kunanirwa k'umutima na fibrillation atriel (AF) bikunze kubana. Abagera kuri 50% byabarwayi bashya bananirwa kumutima bafite fibrillation atriel; Mubibazo bishya bya fibrillation atriel, hafi kimwe cya gatatu bafite ikibazo cyumutima. Biragoye gutandukanya ibitera n'ingaruka zo kunanirwa k'umutima hamwe na fibrillation yo mu mubiri, ariko ku barwayi bafite ikibazo cyo kunanirwa k'umutima na fibrillation yo mu mubiri, ubushakashatsi bwinshi bwerekanye ko gukuraho catheter bigabanya cyane ibyago byo gupfa byose no kunanirwa k'umutima. Nyamara, nta na hamwe muri ubwo bushakashatsi bwarimo abarwayi bafite ikibazo cyo kunanirwa k'umutima barangije hamwe na fibrillation yo mu mubiri, kandi amabwiriza ya vuba aha yerekeranye no kunanirwa k'umutima no gukuraho harimo gukuramo urugero nk'icyiciro cya kabiri ku barwayi bafite ubwoko bwa fibrillation yo mu bwoko bwa fibrillation ndetse no kugabanya uduce duto two gusohora, mu gihe amiodarone ari Icyiciro cya I.

Ubushakashatsi bwa CASTLE-AF bwasohowe mu 2018, bwerekanye ko ku barwayi bafite fibrillation atriyale hamwe no kunanirwa k'umutima, gukuraho catheter byagabanije cyane ibyago byo guhitanwa n'impamvu zose ndetse no kunanirwa k'umutima ugereranije n'imiti. Byongeye kandi, ubushakashatsi butari buke bwemeje kandi inyungu zo gukuraho catheter mu kunoza ibimenyetso, guhindura umutima, no kugabanya imitwaro ya fibrillation. Nyamara, abarwayi bafite fibrillation atriyale hamwe no kunanirwa k'umutima wanyuma akenshi usanga batandukanijwe mubantu biga. Kuri aba barwayi, kohereza ku gihe cyo kwimura umutima cyangwa guterwa igikoresho cy’ibumoso gifasha umuyaga (LVAD) ni ingirakamaro, ariko haracyariho ibimenyetso simusiga bishingiye ku bimenyetso byerekana niba gukuraho catheter bishobora kugabanya urupfu no gutinda gutera LVAD mu gihe utegereje ko haterwa umutima.

Ubushakashatsi bwa CASTLE-HTx bwari ikigo kimwe, gifunguye-ikirango, iperereza ryatangijwe nigeragezwa ryateganijwe ryakozwe neza. Ubushakashatsi bwakorewe kuri Herz- und Diabeteszentrum Nordrhein-Westfale, ikigo cyohereza umutima mu Budage gikora abagera kuri 80 ku mwaka. Kuva mu Gushyingo 2020 kugeza Gicurasi 2022, abarwayi 194 bafite ikibazo cyo kunanirwa k'umutima barangije indwara ya fibrillation ya atriyale basuzumwe ko bemerewe guterwa umutima cyangwa gutera LVAD. Biyandikishije. Abarwayi bose batoranijwe ku kigereranyo cya 1: 1 kugirango bakire catheter yo gukuraho imiti iyobowe nubuyobozi cyangwa kwakira imiti bonyine. Iherezo ryambere ryari rigizwe nimpamvu zose zitera urupfu, gutera LVAD, cyangwa guterwa umutima byihutirwa. Icyiciro cya kabiri cyarimo urupfu rwimpamvu zose, guterwa LVAD, kwimura umutima byihutirwa, gupfa kumutima, no guhinduka mugice cyibumoso cyo gusohora amashanyarazi (LVEF) hamwe numutwaro wa fibrillation atriel mumezi 6 na 12 yo gukurikirana.

Muri Gicurasi 2023 (umwaka umwe nyuma yo kwiyandikisha), Komite ishinzwe gukurikirana amakuru n’umutekano yasanze mu isesengura ry’agateganyo ko ibyabaye ku ndunduro y’ibanze hagati y’ayo matsinda yombi byari bitandukanye cyane kandi ko byari binini kuruta uko byari byitezwe, ko itsinda ryo gukuraho catheter ryarushijeho kuba ryiza kandi ryubahiriza itegeko rya Haybittle-Peto, maze risaba guhagarika gahunda z’ibiyobyabwenge byateganijwe mu bushakashatsi. Abashakashatsi bemeye icyifuzo cya komite cyo guhindura protocole y’inyigisho kugira ngo bagabanye amakuru yakurikiranwe ku iherezo ry’ibanze ku ya 15 Gicurasi 2023.

Guhindura umutima hamwe no gutera LVAD ni ngombwa kugirango tunonosore imenyekanisha ry’abarwayi bafite ikibazo cyanyuma cyumutima wumutima hamwe na fibrillation atriel, nyamara, amikoro make yabaterankunga nibindi bintu bigabanya gukoreshwa kwinshi murwego runaka. Mugihe tugitegereje kwimurwa k'umutima na LVAD, ni iki kindi twakora kugirango tugabanye umuvuduko w'indwara mbere yuko urupfu rutangira? Inyigisho ya CASTLE-HTx ntagushidikanya ko ifite akamaro gakomeye. Ntabwo yemeza gusa ibyiza byo gukuraho catheter kubarwayi bafite AF idasanzwe, ariko inatanga inzira itanga icyizere cyo kugera kubarwayi bafite ikibazo cyumutima wanyuma utoroshye na AF.