恩帕格利弗洛辛对2型糖尿病或糖尿病前期心力衰竭患者左心室体积的影响 (SUGAR- DM- HF)
在PubMed上查看摘要
概括
此摘要是机器生成的。像empagliflozin这样的- 葡萄糖共载体2抑制剂可以减少心力衰竭患者的心力衰竭率 (HFrEF). 这表明HFrEF糖尿病患者或糖尿病前期患者的治疗结果有所改善.
科学领域
- 心脏病学
- 内分泌学
- 药理学
背景情况
- 已知SGLT2i抑制剂可减少心力衰竭患者的住院和心血管死亡.
- 在HFrEF中SGLT2i对心脏结构和功能的确切影响尚不完全理解.
研究的目的
- 在被诊断为HFrEF和2型糖尿病或糖尿病前期患者中调查empagliflozin的心脏作用.
- 使用心血管磁共振 (CMR) 评估左心室体积和应变.
主要方法
- 进行了一项多中心,随机,双盲,安慰剂对照试验 (SUGAR- DM- HF).
- 患有HFrEF (LV射出分数≤40%) 和2型糖尿病或糖尿病前期的患者每天接受10毫克的empagliflozin或安慰剂.
- 首要结局包括36周用CMR测量LV末体积指数的变化和LV全球纵向应变.
主要成果
- 与安慰剂相比,empagliflozin显著降低了6. 0mL/ m2的LV末缩体积指数 (P=0. 015) 和8. 2mL/ m2的LV末缩体积指数 (P=0. 0042).
- 两组之间没有观察到全球LV纵向变异的显著差异.
- 恩帕格利弗洛辛还导致N端亲B型尿素水平降低了28% (P=0. 038).
结论
- 恩帕格利弗洛辛对心脏结构产生了有利影响,特别是降低了HFrEF和糖尿病或糖尿病前期患者的LV体积.
- 这些发现表明,反向LV重塑可能是SGLT2抑制剂改善HFrEF结果的关键机制.
相关概念视频
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...
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...
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
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...
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...
β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...

