Eur J Heart Fail:日常用药短期漏服对心衰病理生理有何影响?

2017-06-13 闫盈盈 吴刚 环球医学

2017年5月,发表在《Eur J Heart Fail》的一项由英国和荷兰科学家进行的研究考察了每日用药的短期遗漏对心衰病理生理的影响。

2017年5月,发表在《Eur J Heart Fail》的一项由英国和荷兰科学家进行的研究考察了每日用药的短期遗漏对心衰病理生理的影响。

目的:心衰的药物治疗旨在改善充血、症状和预后。未服药物是加重心衰的潜在原因。描述短期漏服药物的影响将有助于开发更好的技术和策略来检测和解释心衰加重的原因。研究人员研究了心衰药物遗漏48小时对体重、超声心动图、经胸生物阻抗和NT-proBNP血浆浓度的影响。

方法和结果:在随机交叉试验中,稳定心衰且LVEF<45%的门诊患者分配到服用或遗漏心衰药物48小时组中。纳入了20名患者(16名男性,LVEF为32±9%,中位NT-proBNP为962ng/L)。与常规服药相比,漏服造成NT-proBNP增加99%(从962增加到1883ng/L,P<0.001),收缩压增加16%(从131增加到152mmHg,P<0.001),左心房容积增加21%(从69增加到80mL,P=0.001),经胸生物阻抗降低10%(从33降到30Σ,P=0.001),血清肌酐降低8%(从135降到118μmol/L,P=0.012)。体重、心率或LVEF无显着性改变。

结论:短期漏服的特征为,增加充血,但是与疾病进展的报告模式相反,会增加血压和改善肾功能。稳定心衰患者中,体重并不是短期利尿剂漏服的敏感性标志物

原始出处:

Dovancescu S, Pellicori P, et al. The effects of short-term omission of daily medication on the pathophysiology of heart failure. Eur J Heart Fail. 2017 May;19(5):643-649. doi: 10.1002/ejhf.748. 

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1701764, encodeId=52e81e01764f1, content=<a href='/topic/show?id=9c35e104573' target=_blank style='color:#2F92EE;'>#病理生理#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71045, encryptionId=9c35e104573, topicName=病理生理)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d59730392519, createdName=许安, createdTime=Mon Jun 26 03:02:00 CST 2017, time=2017-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211370, encodeId=9dc02113e0d1, content=感谢小编为我们准备了如此丰盛的精神大餐,同时也向作者致谢!认真学习了,点赞!, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Fri Jun 16 07:04:42 CST 2017, time=2017-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356332, encodeId=a9e7135633238, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Thu Jun 15 08:02:00 CST 2017, time=2017-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562565, encodeId=8337156256505, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Thu Jun 15 08:02:00 CST 2017, time=2017-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1619192, encodeId=b51b161919297, content=<a href='/topic/show?id=049148630cb' target=_blank style='color:#2F92EE;'>#常用药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48630, encryptionId=049148630cb, topicName=常用药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=docwu2019, createdTime=Thu Jun 15 08:02:00 CST 2017, time=2017-06-15, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1701764, encodeId=52e81e01764f1, content=<a href='/topic/show?id=9c35e104573' target=_blank style='color:#2F92EE;'>#病理生理#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71045, encryptionId=9c35e104573, topicName=病理生理)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d59730392519, createdName=许安, createdTime=Mon Jun 26 03:02:00 CST 2017, time=2017-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211370, encodeId=9dc02113e0d1, content=感谢小编为我们准备了如此丰盛的精神大餐,同时也向作者致谢!认真学习了,点赞!, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Fri Jun 16 07:04:42 CST 2017, time=2017-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356332, encodeId=a9e7135633238, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Thu Jun 15 08:02:00 CST 2017, time=2017-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562565, encodeId=8337156256505, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Thu Jun 15 08:02:00 CST 2017, time=2017-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1619192, encodeId=b51b161919297, content=<a href='/topic/show?id=049148630cb' target=_blank style='color:#2F92EE;'>#常用药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48630, encryptionId=049148630cb, topicName=常用药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=docwu2019, createdTime=Thu Jun 15 08:02:00 CST 2017, time=2017-06-15, status=1, ipAttribution=)]
    2017-06-16 ylzr123

    感谢小编为我们准备了如此丰盛的精神大餐,同时也向作者致谢!认真学习了,点赞!

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1701764, encodeId=52e81e01764f1, content=<a href='/topic/show?id=9c35e104573' target=_blank style='color:#2F92EE;'>#病理生理#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71045, encryptionId=9c35e104573, topicName=病理生理)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d59730392519, createdName=许安, createdTime=Mon Jun 26 03:02:00 CST 2017, time=2017-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211370, encodeId=9dc02113e0d1, content=感谢小编为我们准备了如此丰盛的精神大餐,同时也向作者致谢!认真学习了,点赞!, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Fri Jun 16 07:04:42 CST 2017, time=2017-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356332, encodeId=a9e7135633238, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Thu Jun 15 08:02:00 CST 2017, time=2017-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562565, encodeId=8337156256505, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Thu Jun 15 08:02:00 CST 2017, time=2017-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1619192, encodeId=b51b161919297, content=<a href='/topic/show?id=049148630cb' target=_blank style='color:#2F92EE;'>#常用药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48630, encryptionId=049148630cb, topicName=常用药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=docwu2019, createdTime=Thu Jun 15 08:02:00 CST 2017, time=2017-06-15, status=1, ipAttribution=)]
    2017-06-15 zhaojie88
  4. [GetPortalCommentsPageByObjectIdResponse(id=1701764, encodeId=52e81e01764f1, content=<a href='/topic/show?id=9c35e104573' target=_blank style='color:#2F92EE;'>#病理生理#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71045, encryptionId=9c35e104573, topicName=病理生理)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d59730392519, createdName=许安, createdTime=Mon Jun 26 03:02:00 CST 2017, time=2017-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211370, encodeId=9dc02113e0d1, content=感谢小编为我们准备了如此丰盛的精神大餐,同时也向作者致谢!认真学习了,点赞!, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Fri Jun 16 07:04:42 CST 2017, time=2017-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356332, encodeId=a9e7135633238, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Thu Jun 15 08:02:00 CST 2017, time=2017-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562565, encodeId=8337156256505, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Thu Jun 15 08:02:00 CST 2017, time=2017-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1619192, encodeId=b51b161919297, content=<a href='/topic/show?id=049148630cb' target=_blank style='color:#2F92EE;'>#常用药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48630, encryptionId=049148630cb, topicName=常用药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=docwu2019, createdTime=Thu Jun 15 08:02:00 CST 2017, time=2017-06-15, status=1, ipAttribution=)]
    2017-06-15 slcumt
  5. [GetPortalCommentsPageByObjectIdResponse(id=1701764, encodeId=52e81e01764f1, content=<a href='/topic/show?id=9c35e104573' target=_blank style='color:#2F92EE;'>#病理生理#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71045, encryptionId=9c35e104573, topicName=病理生理)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d59730392519, createdName=许安, createdTime=Mon Jun 26 03:02:00 CST 2017, time=2017-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211370, encodeId=9dc02113e0d1, content=感谢小编为我们准备了如此丰盛的精神大餐,同时也向作者致谢!认真学习了,点赞!, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Fri Jun 16 07:04:42 CST 2017, time=2017-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356332, encodeId=a9e7135633238, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Thu Jun 15 08:02:00 CST 2017, time=2017-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562565, encodeId=8337156256505, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Thu Jun 15 08:02:00 CST 2017, time=2017-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1619192, encodeId=b51b161919297, content=<a href='/topic/show?id=049148630cb' target=_blank style='color:#2F92EE;'>#常用药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48630, encryptionId=049148630cb, topicName=常用药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=docwu2019, createdTime=Thu Jun 15 08:02:00 CST 2017, time=2017-06-15, status=1, ipAttribution=)]

相关资讯

Am Heart J:美国心衰成人患者医疗卫生支出呈显著增加趋势

心衰(HF)相关支出趋势的基于人群的全国数据是缺乏的。2017年4月,发表在《Am Heart J》的一项研究使用国家医疗支出小组调查的10年数据(2002~2011)评估美国HF成人患者医疗卫生支出趋势。

JACC:心衰患者给予β-受体阻滞剂很大耐受剂量 还有改善的空间吗?

心衰(HF)患者给予β-受体阻滞剂最大耐受剂量,其还有改善的空间吗?2017年5月,发表在《J Am Coll Cardiol》的一项综述总结了发表的β-受体阻滞剂改善临床结局的机制的报告,描述了里程碑式临床试验和常规临床实践中β-受体阻滞剂剂量的差异,进一步探讨了不耐受的理由以及β-受体阻滞剂的使用剂量和作为治疗目标的心率背后的证据。

JACC: Heart Failure:独辟蹊径!JACC称评估心衰病情可用18米步行试验:超过31秒风险增加

俄亥俄州立大学学者近日在JACC上发表文章提出一个用于评估心衰患者心功能的新的运动试验——60英尺(约18米)步行试验。该方法实施起来要比6分钟步行时间更加简单、易行。

SCI REP:左心室血流动力作为左束支传导阻滞心力衰竭患者的机械不同步的一个标志!

由此可见,机械不同步的这种独特的流量特异性指标可以作为一个额外的工具,考虑到心衰患者传导异常的风险,并且被证实在预测对CRT的反应上也是有用的。

盘点:近期心衰重要研究进展汇总

心力衰竭是由于心脏的收缩功能和或舒张功能发生障碍,不能将静脉回心血量充分排出心脏,导致静脉系统血液淤积,动脉系统血液灌注不足,从而引起心脏循环障碍症候群,此种障碍症候群集中表现为肺淤血、腔静脉淤血。心力衰竭并不是一个独立的疾病,而是心脏疾病发展的终末阶段。这里梅斯小编整理了近期关于心衰的重要研究进展与大家一同分享。【1】Circ-Heart Fail:心内压力测量值可作为慢性心衰患者死亡率的预

JACC:β-受体阻滞剂和心率对心衰患者预后的影响!

目前,对于伴有窦性节律或房颤的心衰患者,心率与其死亡率的关系尚未明确。近日,在国际心血管权威杂志JACC上发表了一篇荟萃分析,旨在分析探讨随机对照试验比较β-受体阻滞剂和安慰剂对心力衰竭患者心率的预后重要性。