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ангиотензин转化酶抑制剂缓解慢性持续性心脏功能障碍的发展随着发作性心肌炎:在中国的一项多中心回顾性研究

Hong Yang^1,2, Wuyun Qidamugai^1,2, Luyun Wang^1,2

¹Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China.

International journal of general medicine

|September 15, 2025

概括

ангиотензин转化酶 (ACE) 抑制剂可以预防慢性心脏功能障碍在充性心肌炎 (FM) 患者治疗临时机械循环支持 (tMCS) 和免疫调节疗法 (IT). 然而,增加左心室终端透缩维度 (LVEDD) 可能会限制它们的长期益处.

科学领域:

心脏病学心脏病学
免疫学免疫学免疫学
药理学药理学是指药理学的学科.

背景情况:

发性心肌炎 (FM) 构成慢性心脏功能障碍的风险,尽管使用临时机械循环支 (tMCS) 和免疫调节疗法 (IT) 进行治疗.
血管激素转化酶 (ACE) 抑制剂在预防FM患者经历TMCS和IT的长期心脏功能障碍方面的作用尚不清楚.

研究的目的:

研究ACE抑制剂在预防FM患者治疗tMCS和IT的慢性持续性心脏功能障碍方面的疗效.
在这个患者群体中确定与左心室射出小部分 (LVEF) 结果相关的临床变量.

主要方法:

这是一项多中心,回顾性,观察性研究,涉及124名FM患者,LVEF≤40%.
患者根据使用ACE抑制剂 (90名患者) 和不使用ACE抑制剂 (34名患者) 的情况进行了分类.
使用后勤回归,子组分析和受限立方脊柱建模来分析心声回声数据并确定随访时LVEF<55%的预测因素.

主要成果:

37.1%的患者在12个月的中位随访期内有LVEF<55%.
不接受ACE抑制剂的患者在24个月内显示LVEF的下降.
多变量分析确定ACE抑制剂具有保护性 (HR = 0.19,P = 0.045) 和增加的LVEDD作为降低LVEF的危险因素 (HR = 9.18,P < 0.001).

结论:

ACE 抑制剂可以改善左心室功能,并减轻 FM 患者的慢性心脏功能障碍.
虽然ACE抑制剂可以部分逆转LV重塑,但长期随访期间LVEDD升高可能会降低其治疗效果.

关键词:

血管激素转化酶抑制剂血管激素转化酶抑制剂慢性持续的心脏功能障碍慢性持续的心脏功能障碍爆发性心肌炎的发生.左心室喷射分数的部分.

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