萨库比特里尔/瓦尔萨坦或埃纳拉普利尔对左心室功能在血液恶性瘤治疗骨髓移植的患者的影响:一个随机对照试验
Konstantinos Katogiannis1, Ignatios Ikonomidis1, Dimitrios Farmakis1
12nd Cardiology Department, Attikon University Hospital, National & Kapodistrian University of Athens, Athens, Greece.
JACC. Advances
|February 21, 2025
概括
在骨髓移植 (BMT) 后,萨库比特里尔/瓦尔萨坦和埃纳拉普利尔可以预防心脏功能障碍. 萨库比特里尔/瓦尔萨坦在心肌工作指数中表现出卓越的改善,为BMT患者提供了一个有前途的心脏保护策略.
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:
- 在骨髓移植 (BMT) 患者中,预防癌症治疗相关心脏功能障碍 (CTRCD) 的证据有限.
- 用BMT治疗的血液性恶性瘤存在心脏并发症的风险.
研究的目的:
- 调查早期启动萨库比特里尔/瓦尔萨坦或埃纳拉普利尔在预防CTRCD后BMT后的疗效.
- 评估这些药物对左心室功能和心肌功能的影响.
主要方法:
- 一项随机试验,涉及90名带有保存左心室喷射分数 (LVEF) 的 BMT 患者.
- 患者被分配给sacubitril/valsartan,enalapril或没有心脏保护药物 (控制).
- 主要终点包括LVEF,LV全球纵向应变 (GLS),心肌浪费工作 (GWW) 和通过心声学评估的工作效率 (GWE).
主要成果:
- 萨库比特里尔/瓦尔萨坦和埃纳拉普利尔组在6个月后没有显示LV GLS或LVEF的恶化.
- 对照组显示LV GLS受损和LVEF降低.
- 萨库比特里尔/瓦尔沙坦组在GWW和GWE中表现出较大的改善,与埃纳拉普利尔和对照组相比.
- 萨库比特里尔/瓦尔萨坦治疗导致LV终端-透气和静脉缩体积的减少.
结论:
- 在BMT后6个月,萨库比特里尔/瓦尔萨坦和埃纳拉普利尔有效地预防了心肌功能恶化.
- 萨库比特里尔/瓦尔萨坦对心肌工作指数产生了更有利的影响.
- 这些发现表明,sacubitril/valsartan和enalapril在 BMT 患者中的潜在心脏保护作用.
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