JACC:神经体液阻断剂的停用对心衰患者的影响

2020-03-28 MedSci原创 MedSci原创

在心脏再同步化治疗后显示正常射血分数的心力衰竭患者中使用神经体液阻滞剂的必要性尚不清楚。本研究的目的是探讨心脏再同步化治疗后正常射血分数患者停用神经体液阻断剂的可行性和安全性。

在心脏再同步化治疗后显示正常射血分数的心力衰竭患者中使用神经体液阻滞剂的必要性尚不清楚。本研究的目的是探讨心脏再同步化治疗后正常射血分数患者停用神经体液阻断剂的可行性和安全性。

本研究纳入分析了80名患者,并随机分成4组(继续神经体液阻断剂治疗,n=20;肾素-血管紧张素-醛固酮系统抑制剂停药,n=20;β-受体阻滞剂停药,n=20;肾素-血管紧张素-醛固酮系统抑制剂和β-受体阻滞剂停药,n=20),主要终点事件是负性重塑的复发,定义为24个月时左室收缩末期容积指数增加>15%。次要终点事件是24个月时全因死亡率、心力衰竭相关住院率和持续性室性心律失常发生率的综合安全终点。最终,分别有6名和4名患者达到主要终点事件和次要终点事件,然而,由于高血压或室上性心律失常,17名受试者重新接受了神经体液阻断剂的治疗。

研究结果显示,主要和次要终点事件的发生率在对照和停用神经体液阻断剂患者中均很低,然而,心脏并发症阻碍了神经体液阻滞剂的停药。

原始出处:

Petra N et al.Withdrawal of Neurohumoral Blockade After Cardiac Resynchronization Therapy.JACC.2020 Mar.

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    2020-06-14 hbwxf
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