节奏适应性心脏衰竭与保存的喷射小部分:RAPID-HF随机临床试验
Yogesh N V Reddy1, Katlyn E Koepp1, Rickey Carter2
1Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.
JAMA
|March 5, 2023
概括
在心脏衰竭和保存喷射分数 (HFpEF) 的慢性无能症患者中,心房节奏并没有改善运动能力,并导致更多的不良事件. 这项研究表明步行对这些患者没有好处.
科学领域:
- 心脏病学
- 运动生理学
背景情况:
- 运动期间心率降低常见于心力衰竭与保留喷射分数 (HFpEF),与有氧能力降低相关.
- 通过心房节奏调节恢复慢性无能期的HFpEF患者的益处尚不清楚.
研究的目的:
- 为了研究是否速度适应性心房节奏改善了具有慢性无能症的症状的HFpEF患者的运动表现.
- 评估心房节奏对氧气消耗,呼吸效率和患者报告的结果的影响.
主要方法:
- 一个单中心,双盲,随机,交叉试验,涉及29名具有慢性无能度的HFpEF患者.
- 参与者被随机分配到4周的心房率响应步调或没有步调,随后是4周的洗和交叉.
- 使用乙再呼吸技术测量运动期间的心脏输出量;主要终点是无氧值 (V·o2,AT) 的氧气消耗.
主要成果:
- 在运动期间,心脏节拍成功地增加了心率,但并没有显著改善V·o2,AT,峰值V·o2或呼吸效率.
- 没有观察到患者报告的健康状况 (KCCQ- OSS) 或NT- proBNP水平的显著改善.
- 节奏导致中风量下降,否定了对心脏输出的任何潜在益处; 21% 的参与者经历了与设备相关的不良事件.
结论:
- 植入心脏起器以提高运动心率,并没有提高慢性无能症患者的运动能力.
- 这种程序与不良事件的发生率增加有关,这表明它对这个患者群体不是有益的干预措施.
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