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亚托瓦斯塔丁和心肌细胞外体积扩张在基于人环素的化疗期间
Vencel Juhasz1, Thiago Quinaglia2, Zsofia D Drobni3
1Cardiovascular Imaging Research Center, Division of Cardiology, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA; Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
亚托瓦斯塔丁显著限制了接受 antracyclines 淋巴瘤患者的心肌细胞外体积扩张,为他类心脏保护提供了新的见解. 这一发现支持阿托瓦斯塔丁的存在.
科学领域:
- 心脏病学 心脏病学
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
背景情况:
- STOP-CA试验显示,阿托瓦斯塔丁在接受环素治疗的淋巴瘤患者中保留了左心室喷射分数.
- 在这种情况下,阿托瓦斯塔丁的心脏保护作用背后的确切机制尚不清楚.
研究的目的:
- 为了研究阿托瓦斯塔丁对心肌细胞外体积 (ECV) 诱导的反循环素增加的影响.
- 使用心脏磁共振成像 (MRI) 评估心电图变化.
主要方法:
- 带有映射的心脏MRI在基线和12个月的随访期间进行.
- 计算了心肌细胞外体积 (ECV),主要终点为≥3%的增加.
- 二级终点包括≥1 SD增加原生T1和T2倍和ECV.
主要成果:
- 与安慰剂相比,接受阿托瓦斯塔丁治疗的患者中显著较少的比例在ECV上升≥3% (8%与29%相比;P=0.002).
- 脑电流≥3%的增加与左心室喷射分数 (P < 0.001) 的8.4%的减少有关.
- 两组之间T1和T2时间没有显著差异;然而,没有ECV扩张的患者心力衰竭事件较少.
结论:
- 与安慰剂相比,阿托瓦斯塔丁有效地限制了接受 antracycline 化疗的淋巴瘤患者的 ECV 扩张.
- 这项研究提供了第一个机制证据,证明了他类药物对抗环素心脏毒性的心脏保护作用.
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