このページは機械翻訳されています。他のページは英語で表示される場合があります。View in English
エムパグリフロジンを服用する心臓機能不全患者の心臓エネルギー代謝,機能および生理学的評価:ランダム化,制御されたEMPA- VISION試験
Moritz J Hundertmark1,2, Amanda Adler3, Charalambos Antoniades4
1Oxford Centre for Clinical Magnetic Resonance Research (M.J.H., H.L., S.M., F.E.M., B.R., O.R., C.T.R., L.V., M.M., S.N.), Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital, UK.
Circulation
|April 18, 2023
PubMed で要約を見る
まとめ
ナトリウム・グルコース共輸送体2阻害剤 (SGLT2i) は,心不全患者の心臓のエネルギー代謝を改善しなかった. この研究は,SGLT2iが心不全に与える効果の背後にあるメカニズムがエネルギー生産の強化である可能性が低いことを示唆しています.
科学分野:
- 心臓病科
- 代謝障害
- 薬理学について
背景:
- ナトリウム・グルコース共輸送体2阻害剤 (SGLT2i) は心不全 (HF) に有効ですが,その心的メカニズムは不明です.
- すべてのHF型では心筋のエネルギー代謝が低下しており,SGLT2iがエネルギー生産を改善する可能性があることを示唆しています.
研究 の 目的:
- エムパグリフロジンが心筋動脈のエネルギー,血清代謝,心臓呼吸器の健康状態を変化させるかどうかを調べる.
- 心不全の治療におけるSGLT2iの潜在的メカニズムを探求する.
主な方法:
- 72人のHF患者 (HFrEFとHFpEF) を対象とした前向きなランダム化,ダブルブラインド,プラセボ対照試験 (EMPA- VISION).
- 患者は12週間にわたって毎日10mgのエンパグリフロジンまたはプラセボを投与された.
- 心臓のエネルギー (PCr/ ATP) は,休息とドブタミンのストレス中にリン磁気共振光譜を用いて測定され,血清代謝値も分析された.
主要な成果:
- プラセボと比較して,Empagliflozinは静止状態またはストレス中の心臓エネルギー (PCr/ ATP) を有意に変化させなかった.
- 血清代謝や循環中のケトンボディに重大な変化は見られなかった.
関連する概念動画
01:30Heart Failure V: Medical Management
17
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
17
01:29Heart Failure II: Pathophysiology
19
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
19
01:26Heart Failure III: Clinical Manifestations
29
Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...
29
01:30Heart Failure IV: Classification and Diagnostic Evaluation
22
Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
22
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
474
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
474
01:17Pathophysiology of Heart Failure
1.7K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
1.7K