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 uheruka hamwe na fibrillation yo mu mubiri, kandi amabwiriza aheruka yerekeranye no kunanirwa k'umutima no gukuraho harimo no gukuraho nk'icyiciro cya kabiri ku barwayi bafite ubwoko ubwo ari bwo bwose bwa fibrillation yo mu nda no kugabanya igice cyo gusohora, mu gihe mu gihe amiodarone nicyiciro cya I cyifuzo

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 mu gihe gikwiye cyo guterwa 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 gutinza LVAD mu gihe utegereje umutima transplantation.

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.Abarwayi 194 bafite ikibazo cyo kunanirwa k'umutima barangije bafite fibrillation ya atrique basuzumwe ko bemerewe guterwa umutima cyangwa gutera LVAD biyandikishije kuva mu Gushyingo 2020 kugeza Gicurasi 2022. Abarwayi bose bari bafite ibikoresho byumutima byatewe no gukurikirana injyana y'umutima.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 birenze ibyo byari byitezwe, ko itsinda ryo gukuraho catheter ryarushijeho gukora neza kandi ryubahiriza itegeko rya Haybittle-Peto, kandi risaba guhagarika bidatinze gahunda y’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.