在患有晚期心力衰竭和减少喷射分数的患者中使用SGLT2抑制剂治疗
Vincenzo Nuzzi1, Paolo Manca1, Francesca Parisi1
1Clinical Cardiology and Heart Failure Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy.
Current problems in cardiology
|August 29, 2024
概括
-葡萄糖携带载体抑制剂 (SGLT2-i) 在发达心力衰竭与减少射出分数 (HFrEF) 中显示出有限的益处. 这些SGLT2-i并没有改善晚期HFrEF患者的NTproBNP水平或临床结果,尽管它们被很好地容忍.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- -葡萄糖携带载体抑制剂 (SGLT2-i) 已被确立为心力衰竭的治疗方法,其排气分数减少 (HFrEF).
- 关于SGLT2-i在患有高级HFrEF的患者中有效性的数据有限.
研究的目的:
- 评估SGLT2-i在高级HFrEF中的效果,与非高级HFrEF相比.
- 评估SGLT2-i对这些人群中N端前脑性尿素 (NTproBNP) 水平和临床参数的影响.
主要方法:
- 一组105名HFrEF门诊患者开始SGLT2-i被分为高级和非高级的HF组.
- 主要结果:NTproBNP趋势. 二级结局:纽约心脏协会 (NYHA) 类,膜过率 (GFR) 和左心室喷射率 (LVEF) 的变化.
- 多变量分析评估了高级HF和NTproBNP减少之间的关联.
主要成果:
- 高级HFrEF患者的NTproBNP增加,而非高级患者的NTproBNP显著减少 (-32%).
- 在LVEF和NYHA等级的改善仅在非高级组中观察到.
- 先进的HF诊断独立地与较低的NTproBNP减少概率相关 (OR 0.041,p=0.031).
结论:
- 在患有高级HFrEF的患者中,SGLT2-i不会显著影响NTproBNP,LVEF或NYHA类.
- 在先进的HFrEF患者中,SGLT2-i被很好地容忍.
- 目前的证据表明,在HFrEF的晚期阶段,SGLT2-i可能不那么有效.
更多相关视频
07:09A Surgical Model of Heart Failure with Preserved Ejection Fraction in Tibetan Minipigs
Published on: February 18, 2022
1.8K
09:11Cell-based Therapy for Heart Failure in Rat: Double Thoracotomy for Myocardial Infarction and Epicardial Implantation of Cells and Biomatrix
Published on: September 22, 2014
11.9K
相关概念视频
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
404
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...
404
01:22Heart Failure Drugs: Diuretics
352
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...
352
01:26Heart Failure Drugs: Inotropic Agents
545
Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
545
01:22Heart Failure Drugs: β-Blockers
322
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,...
322
01:17Pathophysiology of Heart Failure
1.5K
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...
1.5K
01:22Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers
1.3K
Class I antiarrhythmic drugs are used to treat various types of arrhythmias or irregular heart rhythms. These drugs block the sodium (Na+) channels in the cardiac cells, thereby affecting the movement of electrical impulses across the heart. Class I antiarrhythmic drugs are divided into three subgroups: Class IA, Class IB, and Class IC, each with distinct mechanisms of action and effects on the heart.
Class 1A Antiarrhythmic Drugs: These drugs work by moderately blocking sodium channels,...
Class 1A Antiarrhythmic Drugs: These drugs work by moderately blocking sodium channels,...
1.3K