Med Sci:提高β受体阻滞剂的剂量可减少与心力衰竭有关的住院和心律失常事件

2020-03-19 MedSci原创 MedSci原创

临床试验表明,β受体阻滞剂治疗对心力衰竭患者射血分数降低的益处。这些好处包括提高生存率和减少住院需求。尽管有最佳的药物治疗方法,但心脏再同步治疗已成为一种以设备为基础的必不可少的治疗方法,可

临床试验表明,β受体阻滞剂治疗对心力衰竭患者射血分数降低的益处。这些好处包括提高生存率和减少住院需求。尽管有最佳的药物治疗方法,但心脏再同步治疗已成为一种以设备为基础的必不可少的治疗方法,可用于有心力衰竭的有症状患者的射血分数降低。β受体阻滞剂在接受心脏再同步治疗的患者中被利用的程度尚不清楚。在这项研究中,我们评估了在有心脏再同步治疗能力的除颤器系统植入后,未选择的心力衰竭队列射血减少患者中增加β受体阻滞剂剂量的可能性,以及β受体阻滞剂治疗与临床结局之间的相关性。

 

该研究纳入了2008年7月至2016年12月间接受过心脏再同步治疗的除颤器系统植入的β受体阻滞剂治疗引起的心力衰竭患者射血分数降低的研究。在出院时和随访期间确定β受体阻滞剂的剂量。记录心血管疾病的死亡率,因心力衰竭加重或心律失常而住院的时间以及对器械的适当干预。

 

该研究队列包括480位患者,其中289位患者(60.3%)的β受体阻滞剂剂量等于CRT之前的剂量(组1),191位患者(39.7%)的β受体阻滞剂剂量比CRT植入前的剂量高(组2)。与两组相比,第2组的心血管死亡率,与心力衰竭相关的住院治疗和心律失常事件的发生率均低于第1组。

 

总之,该研究结果表明,启动CRT后,可以安全地以更高的剂量提高β受体阻滞剂的剂量,从而降低死亡率,减少与心力衰竭有关的住院和心律失常事件。

 

原始出处:

 

Daniele MasaroneMarina Verrengia, et al., Beta Blockers Up-Titration in Patients with Heart Failure Reduced Ejection Fraction and Cardiac Resynchronization Therapy, a Single Center Study. Med Sci (Basel). 2019 Jun; 7(6): 71. doi: 10.3390/medsci7060071

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    2020-06-28 zhyy88
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