在心力衰竭与保存喷射分数的trimetazidine:一个随机对照交叉试验
Arno A van de Bovenkamp1,2, Kiki T J Geurkink1, Frank T P Oosterveer3
1Department of Cardiology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
ESC heart failure
|August 2, 2023
概括
在心力衰竭患者中,trimetazidine未能改善心脏功能,并保留了喷射分数 (HFpEF). 该研究发现,随着三甲丁治疗,运动能力或心肌能量状况没有显著的益处.
科学领域:
- 心脏病学 心脏病学
- 代谢医学是一种代谢医学.
- 运动生理学 运动生理学
背景情况:
- 心肌能量稳定性受损是心力衰竭的关键因素,具有保留喷射分数 (HFpEF) 病理生理学.
- 左心室扩张功能障碍,在放松期间具有高能量需求的特征,与能量代谢受损有关.
研究的目的:
- 研究脂肪酸氧化抑制剂trimetazidine在增强心肌能量恒温方面的疗效.
- 为了确定三甲是否改善了诊断为HFpEF的患者的运动血液动力学.
主要方法:
- 一个第二阶段,单中心,双盲,安慰剂控制,随机交叉试验 (DoPING-HFpEF) 涉及25名HFpEF患者.
- 患者接受了三甲素或安慰剂3个月,随后是2周的洗期.
- 主要终点:运动期间肺毛细血管压力变化;次要终点:心肌酸/腺三酸盐比率.
主要成果:
- 与安慰剂相比,trimetazidine在运动期间没有显著改变肺毛细血管压力 (平均变化为0 mmHg,P=0.60).
- 肌肉中酸/腺三酸盐水平在三甲胺和安慰剂组之间相似 (P=0.08).
- 没有观察到运动能力 (6分钟步行距离),生活质量或扩张功能参数的改善.
结论:
- 在患有HFpEF的患者中,trimetazidine不会改善心肌能量恒温.
- 该药物未能在研究的HFpEF人群中增强运动血液动力学或其他临床参数.
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