与女性相比,在男性中确定心力衰竭药物的最佳剂量:前性观察性队列研究
Bernadet T Santema1, Wouter Ouwerkerk2, Jasper Tromp3
1Department of Cardiology, University Medical Center Groningen, Groningen, Netherlands.
Lancet (London, England)
|August 27, 2019
概括
与男性相比,患有心力衰竭减排分数 (HFrEF) 的女性可能受益于较低剂量的ACE抑制剂或ARB和β阻塞剂. 这一发现质疑基于性别的HFrEF患者的最佳治疗方法.
科学领域:
- 心脏病学
- 药理学
- 临床医学
背景情况:
- 在心力衰竭中使用ACE抑制剂/ARB和β阻塞剂的指导剂量与男性和女性相似.
- 已知药物的药理动力学的性别差异表明性别特定的最佳剂量可能存在.
研究的目的:
- 对于患有HFrEF的患者来说,研究最佳ACE抑制剂/ ARB和β抑制剂的潜在性别差异.
主要方法:
- 随机分析BIOSTAT- CHF研究,包括左心室喷射分数< 40% 的患者.
- 在独立的ASIAN-HF队列中进行验证.
- 主要结局:综合所有原因死亡率或心力衰竭住院.
主要成果:
- 患有HFrEF的女性年龄较大,体重和身高低于男性.
- 在男性中,ACE抑制剂/ ARBs和β阻塞剂的指导剂量达到100%时,死亡率或HF住院的风险降低最佳.
- 在女性中,使用指导剂量的50%降低了风险,高剂量没有额外的益处.
结论:
- 患有HFrEF的女性可能需要比男性更低的ACE抑制剂/ARB和β抑制剂.
- 这表明需要重新评估基于性别的差异对HFrEF的最佳治疗方法.
更多相关视频
07:49Author Spotlight: Investigating HR-Dependent Cardiac Function in Mouse Models Through a Novel Atrial-Pacing Approach
Published on: July 21, 2023
1.9K
08:42Design and Implementation of an fMRI Study Examining Thought Suppression in Young Women with, and At-risk, for Depression
Published on: May 19, 2015
11.2K
相关概念视频
Heart Failure V: Medical Management
225
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...
225
Renal Failure: Dose Adjustments
440
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
440
Heart Failure II: Pathophysiology
768
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...
768
Pathophysiology of Heart Failure
3.0K
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...
3.0K
Heart Failure I: Introduction
720
Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
720
Heart Failure VI: Adjunct Therapies
273
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
273
