晚期心力衰竭中循环中的β-基酸盐水平与减少喷射分数:决定因素和预后影响
Luca Monzo1,2, Jan Kovar1, Barry A Borlaug3
1Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic.
European journal of heart failure
|June 10, 2024
概括
在晚期心力衰竭中,减少喷射分数 (HFrEF),升高的β-基酸盐 (β-OHB) 水平与自由脂肪酸 (FFA) 相相关. 然而,FFA,而不是β-OHB,预测了不良结果,这表明β-OHB反映了脂解,而不是导致HF恶化.
科学领域:
- 心脏病学 心脏病学
- 代谢医学是一种代谢医学.
- 生物化学 生化学
背景情况:
- 减少喷射分数 (HFrEF) 的心力衰竭与代谢失调有关.
- 在HFrEF患者中观察到生成和β-甲酸 (β-OHB) 的增加.
- 在高级HFrEF中β-OHB的临床意义需要进一步调查.
研究的目的:
- 检查高级HFrEF中循环β-OHB水平的决定因素.
- 评估β-OHB对HFrEF临床结果的预后影响.
- 为了澄清β-OHB,脂解和HF严重程度之间的关系.
主要方法:
- 该研究包括867名患有高级HFrEF的患者.
- 进行了临床,心声和代谢物评估.
- 在一小部分患者中使用了右心导管.
- 后续评估复合事件,包括死亡率和设备植入.
主要成果:
- 中位数β-OHB为64μmol/L,较高的水平与增加的自由脂肪酸 (FFA),尿酸和更差的血液动力学有关.
- 无变量分析显示,β-OHB和FFA都预测了更糟糕的预后.
- 多变量分析显示FFA,但不是β-OHB,仍然是不良结果的独立预测因素.
结论:
- 在先进的HFrEF中,升高的β-OHB与脂解和HF严重性标志物有关.
- 在对FFA进行调整后,β-OHB的预后关联减弱.
- 增加的β-OHB似乎是升高脂解的标志物,而不是HF进展的独立驱动因素.
更多相关视频
10:21Evaluation of Hydration Status by Bioelectrical Impedance Vector Analysis in Patients with Ischemic Heart Disease Undergoing Exercise Stress Test
Published on: September 22, 2023
615
04:36Measurement of Tissue Oxygenation Using Near-Infrared Spectroscopy in Patients Undergoing Hemodialysis
Published on: October 2, 2020
2.2K
相关概念视频
01:17Pathophysiology of Heart Failure
1.6K
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...
1.6K
01:22Heart Failure Drugs: β-Blockers
336
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,...
336
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
77
Cardiac biomarkers are critical in diagnosing, prognosing, and managing cardiovascular diseases. Routine measurement of specific biomarkers such as B-type natriuretic peptide (BNP), C-reactive protein (CRP), and homocysteine (Hcy) is common practice in clinical settings to evaluate heart function and predict cardiovascular events.
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
77
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
421
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...
421
01:22Heart Failure Drugs: Diuretics
363
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...
363
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
137
Cardiac biomarkers are enzymes, proteins, and hormones released into the blood when cardiac cells are injured. They are powerful tools for triaging.
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
137