长期结果:在心力衰竭患者中使用β-阻塞剂和永久性节奏,保持了喷射分数
James K Gabriels1, Kristie Coleman1, Joanna Fishbein2
1Northwell Cardiovascular Institute, Center for Arrhythmias, New Hyde Park, New York, USA.
JACC. Advances
|December 16, 2025
概括
患有保留喷射分数 (HFpEF) 的心力衰竭患者可能受益于β抑制剂和永久起器 (PPM) 植入. 在这项大型研究中,这两种疗法都与降低死亡风险有关.
科学领域:
- 心脏病学 心脏病学
- 临床医学 临床医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 保存喷射分数 (HFpEF) 的心力衰竭是一个重大的全球健康挑战.
- 目前对HFpEF的治疗选择缺乏已证明的死亡率益处.
研究的目的:
- 调查β-阻断剂治疗和永久心脏起器 (PPM) 植入对HFpEF患者死亡率的长期影响.
- 评估这些干预措施对患者结果的综合影响.
主要方法:
- 一项回顾性队列研究分析了来自11家医院的22,308名HFpEF患者的数据.
- 检查了β-阻断剂使用和PPM植入与所有原因死亡率,医院再入院和急诊室访问的关联.
- 随访时间的中位数为1.5年.
主要成果:
- 服用β-阻断剂的出院与20%较低的死亡风险相关 (HR:0.80).
- 在出院时植入永久起器 (PPM) 与32%的死亡风险降低有关 (HR:0.68).
- 显著比例的患者 (44.3%) 服用β-阻断剂出院,而4.2%接受了PPM (单独或与β-阻断剂一起).
结论:
- 贝塔抑制剂治疗和永久心脏起器 (PPM) 植入似乎独立地与HFpEF患者的生存率改善有关.
- 这些发现表明,这些干预措施在管理HFpEF时具有潜在的治疗益处.
- 进一步的研究可能会阐明最佳的患者选择和治疗策略.
相关概念视频
01:22Heart Failure Drugs: β-Blockers
729
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,...
729
01:30Heart Failure V: Medical Management
198
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
198
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
879
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...
879
01:22Heart Failure VI: Adjunct Therapies
235
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
235
01:30Cardiomyopathy II: Dilated Cardiomyopathy
436
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
436
01:26Heart Failure Drugs: Inotropic Agents
1.2K
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...
1.2K