Journal of Cardiovascular Pharmacology最新文献_第5页

Immunoglobulin-mediated Cardiac Protection from Ischemia/Reperfusion Injury in Diabetic Rats is associated with Endothelial Nitric Oxide Synthase/Glucose Transporter-4 Signaling Pathway 免疫球蛋白介导的糖尿病大鼠心脏缺血再灌注损伤保护与内皮一氧化氮合成酶/葡萄糖转运体-4 信号通路有关

IF 2.6 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Pharmacology

Pub Date : 2024-07-16 DOI: 10.1097/fjc.0000000000001586

Fawzi Babiker, Aisha Al-Kouh

The role of intravenous immunoglobulin in protecting the diabetic heart from ischemia/reperfusion (I/R) injury is unclear. Hearts isolated from adult diabetic and non-diabetic Wistar rats (n=8 per group) were treated with intravenous immunoglobulin (IVIG) either two hours before euthanasia, before ischemia, or at reperfusion. Hemodynamic data were acquired using the Isoheart software version 1.524-S. Ischemia/reperfusion (I/R) injury was evaluated by 2,3,5-Triphenyltetrazolium chloride staining and troponin T levels. The levels of apoptosis markers, caspases-3/8, antioxidant enzymes, superoxide dismutase and catalase, glucose transporters, GLUT-1 and GLUT-4, phosphorylated ERK1/2, and phosphorylated eNOS were estimated by Western blotting. Pro- and anti-inflammatory cytokine levels were evaluated using enzyme-linked immunosorbent assays. Intravenous immunoglobulin administration abolished the effects of I/R injury in hearts subjected to hyperglycemia when infused at reperfusion, before ischemia, or at reperfusion in four-week diabetic rat hearts and only at reperfusion in six-week diabetic rat hearts. IVIG infusion resulted in a significant (P<0.05) recovery of cardiac hemodynamics and decreased infarct size. IVIG also reduced the levels of troponin T, apoptotic enzymes, and pro-inflammatory cytokines. IVIG significantly (P<0.05) increased the levels of anti-inflammatory cytokines, antioxidant enzymes, GLUT-4, and phosphorylated eNOS. Intravenous immunoglobulin protected the hearts from I/R injury if infused at reperfusion in the presence of hyperglycemia, in four- and six-week diabetic rat hearts, and when infused before ischemia in four-week diabetic rat hearts. IVIG exerts its cardioprotective effects associated with the upregulated phosphorylated eNOS/GLUT-4 pathway.

静脉注射免疫球蛋白在保护糖尿病心脏免受缺血再灌注（I/R）损伤方面的作用尚不清楚。在安乐死前两小时、缺血前或再灌注时用静脉注射免疫球蛋白（IVIG）处理从成年糖尿病和非糖尿病 Wistar 大鼠（每组 8 只）分离的心脏。使用 Isoheart 软件 1.524-S 版获取血液动力学数据。缺血/再灌注（I/R）损伤通过2,3,5-三苯基氯化四氮唑染色和肌钙蛋白T水平进行评估。通过 Western 印迹法评估了细胞凋亡标志物、caspases-3/8、抗氧化酶、超氧化物歧化酶和过氧化氢酶、葡萄糖转运体、GLUT-1 和 GLUT-4、磷酸化 ERK1/2 和磷酸化 eNOS 的水平。使用酶联免疫吸附试验评估了促炎和抗炎细胞因子的水平。在再灌注时、缺血前或再灌注时，静脉注射免疫球蛋白可消除高血糖心脏I/R损伤的影响；在再灌注时，静脉注射免疫球蛋白可消除四周糖尿病大鼠心脏I/R损伤的影响；在再灌注时，静脉注射免疫球蛋白可消除六周糖尿病大鼠心脏I/R损伤的影响。输注 IVIG 后，心脏血流动力学明显恢复（P<0.05），梗死面积缩小。IVIG 还降低了肌钙蛋白 T、凋亡酶和促炎细胞因子的水平。IVIG 能明显（P<0.05）提高抗炎细胞因子、抗氧化酶、GLUT-4 和磷酸化 eNOS 的水平。在有高血糖的情况下，静脉注射免疫球蛋白可保护心脏免受再灌注损伤；在四周和六周糖尿病大鼠心脏中，静脉注射免疫球蛋白可保护心脏免受再灌注损伤；在四周糖尿病大鼠心脏缺血前，静脉注射免疫球蛋白可保护心脏免受再灌注损伤。IVIG 的心脏保护作用与磷酸化 eNOS/GLUT-4 通路的上调有关。

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引用次数: 0

Levosimendan as an Antidote in Experimental Calcium Channel Blocker Intoxication 左西孟旦作为实验性钙通道阻滞剂中毒的解毒剂

IF 2.6 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Pharmacology

Pub Date : 2024-07-16 DOI: 10.1097/fjc.0000000000001612

J. Levijoki, M. Kivikko, Piero Pollesello

The effects of the calcium sensitizer levosimendan on hemodynamics and survival in guinea pigs intoxicated with the calcium blockers verapamil or diltiazem were evaluated in a randomized controlled study. 104 animals were randomized to be intoxicated with either verapamil (2.0 mg/kg) or diltiazem (4.5 mg/kg) and thereafter further randomized into six groups which received either saline (control), three different regimes of levosimendan, calcium chloride, and levosimendan combined with calcium chloride. The hemodynamics and survival of the animals were followed for 60 min after intoxication. The negative inotropic effect of calcium blockers was seen as a decrease by over 70% of the positive derivative of the left ventricular pressure. This was reversed by levosimendan. Moreover, both verapamil and diltiazem induced marked hypotension (-69 and -63% of the baseline value respectively) which was also reversed by levosimendan. The combined levosimendan and calcium chloride treatment had a synergistic effect in reversing verapamil or diltiazem-induced deterioration in hemodynamics. Both verapamil and diltiazem intoxications decreased the survival rate of guinea pigs to 13%. Levosimendan addition improved survival dose-dependently up to a survival rate of 75% and 88% in the verapamil and diltiazem groups, respectively. Low dose of levosimendan combined with calcium chloride improved survival in verapamil and diltiazem group to 88% and 100%, respectively. In conclusion, the administration of levosimendan improved hemodynamics and survival in calcium channel blocker intoxicated guinea pigs. The synergistic effect of levosimendan and calcium chloride suggests that this combination could be an effective antidote in calcium channel blocker intoxications.

一项随机对照研究评估了钙敏化剂左西孟旦对钙阻滞剂维拉帕米或地尔硫卓中毒豚鼠血液动力学和存活率的影响。104 只豚鼠被随机分为维拉帕米（2.0 毫克/千克）或地尔硫卓（4.5 毫克/千克）两组，然后再随机分为六组，分别接受生理盐水（对照组）、三种不同剂量的左西孟旦、氯化钙和左西孟旦联合氯化钙。在中毒后的 60 分钟内，对动物的血液动力学和存活率进行了跟踪。钙离子阻滞剂的负性肌力作用表现为左心室压力正导数下降 70% 以上。左西孟旦可逆转这种情况。此外，维拉帕米和地尔硫卓都会引起明显的低血压（分别为基线值的-69%和-63%），左西孟旦也能逆转这种情况。左西孟旦和氯化钙联合治疗在逆转维拉帕米或地尔硫卓引起的血流动力学恶化方面具有协同作用。维拉帕米和地尔硫卓中毒均使豚鼠的存活率降至 13%。添加左西孟旦后，维拉帕米组和地尔硫卓组的存活率分别达到 75% 和 88%，存活率的提高与剂量有关。小剂量左西孟旦联合氯化钙可将维拉帕米组和地尔硫卓组的存活率分别提高到 88% 和 100%。总之，服用左西孟旦可改善钙通道阻滞剂中毒豚鼠的血液动力学和存活率。左西孟旦和氯化钙的协同作用表明，这两种药物可以成为钙通道阻滞剂中毒的有效解毒剂。

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引用次数: 0

Cardiovascular outcomes of SGLT-2 Inhibitors Across BMI Spectrum in Heart Failure Patients: An Updated Systematic Review and Meta-Analysis SGLT-2抑制剂对不同BMI指数的心衰患者的心血管疗效：最新系统综述和元分析

IF 2.6 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Pharmacology

Pub Date : 2024-07-08 DOI: 10.1097/fjc.0000000000001610

Lingyan Zhou, Huang Zijia, Zeng Ya, Zhang Ying

Sodium-glucose cotransporter 2 (SGLT-2) inhibitors have shown efficacy in improving cardiovascular outcomes in patients with chronic heart failure (HF). However, their impact on HF patients with varying BMI levels remains uncertain. To explore potential interactions between baseline BMI and the cardiovascular benefits of SGLT-2 inhibitors, we conducted a systematic review of studies from PubMed, Scopus, and the Cochrane Library database spanning from inception to March 2024. Eligible studies reported cardiovascular outcomes according to baseline BMI in HF patients treated with SGLT-2 inhibitors. Ultimately, our analysis included four studies encompassing 20,723 patients. We conducted separate random-effects meta-analyses for the composite outcome of first hospitalization for heart failure (HHF) or cardiovascular death (CVD), total HHF, CVD, and all-cause mortality. Compared with placebo, SGLT-2 inhibitors significantly reduced the risk of the composite outcome of first HHF or CVD (HR = 0.78, 95% CI: 0.72-0.83) and total HHF (HR = 0.73, 95% CI: 0.61-0.83), with consistent effects observed across different BMI categories (test for subgroup differences: P = 0.63 and P = 0.56, respectively). Furthermore, no statistical heterogeneity was found in the effects of SGLT-2 inhibitors on CVD (P = 0.84, I 2 = 0%) as well as all-cause mortality (P = 0.52, I 2 = 0%) across each baseline BMI subgroup in HF patients. No significant difference in safety was found between the placebo and SGLT-2 inhibitor arms. In conclusion, our findings suggest that the cardiovascular benefits of SGLT-2 inhibitors appear to be independent of baseline BMI in HF patients.

钠-葡萄糖共转运体 2（SGLT-2）抑制剂在改善慢性心力衰竭（HF）患者的心血管预后方面已显示出疗效。然而，它们对不同体重指数水平的心力衰竭患者的影响仍不确定。为了探索基线体重指数与 SGLT-2 抑制剂对心血管的益处之间的潜在相互作用，我们对 PubMed、Scopus 和 Cochrane Library 数据库中从开始到 2024 年 3 月的研究进行了系统性回顾。符合条件的研究报告了接受 SGLT-2 抑制剂治疗的高血压患者根据基线体重指数得出的心血管结果。最终，我们的分析包括了四项研究，涉及 20,723 名患者。我们对首次心衰（HHF）住院或心血管死亡（CVD）、总HHF、CVD和全因死亡率的复合结果分别进行了随机效应荟萃分析。与安慰剂相比，SGLT-2 抑制剂可显著降低首次 HHF 或 CVD（HR = 0.78，95% CI：0.72-0.83）和总 HHF（HR = 0.73，95% CI：0.61-0.83）综合结果的风险，在不同 BMI 类别中观察到一致的效果（亚组差异检验：分别为 P = 0.63 和 P = 0.56）。此外，SGLT-2抑制剂对心血管疾病（P = 0.84，I 2 = 0%）和全因死亡率（P = 0.52，I 2 = 0%）的影响在高血压患者的每个基线BMI亚组中均未发现统计学异质性。安慰剂组和 SGLT-2 抑制剂组在安全性方面无明显差异。总之，我们的研究结果表明，SGLT-2 抑制剂对心血管的益处似乎与心房颤动患者的基线体重指数无关。

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引用次数: 0

Ivabradine approved and other uses in clinical practice: a systematic review 伊伐布雷定在临床实践中的批准用途和其他用途：系统综述

IF 2.6 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Pharmacology

Pub Date : 2024-07-08 DOI: 10.1097/fjc.0000000000001609

Mohsen Hajiqasemi, Mandana Ebrahimzade, Zahra Ghelichkhan, Xena Huang, Demyana Morkos, Douglas Jennings, Azita H Talasaz

Heart rate (HR) stands as a prognostic indicator of cardiovascular disease and a modifiable risk factor in heart failure (HF). Medication intolerance can curtail the application of conventional HR-lowering β-blockers to the optimum target dose. Ivabradine (IVA), a specific negative-chronotropic agent, selectively inhibits If current in pacemaker cells of the sinoatrial node without depressing myocardial contractility or comprising hemodynamics. This review summarized ivabradine’s clinical labeled and off-label uses, and mechanism of action focusing on the clinical outcomes. PubMed was searched up to January 2024 using the main keywords of IVA, coronary artery disease (CAD), HF, postural orthostatic tachycardia syndrome (POTS) and tachyarrhythmia. To comprehensively review IVA’s clinical indications, mechanisms, and therapeutic effects, all studies investigating treatment with IVA in humans were included, comprising different types of studies such as randomized controlled trials (RCTs) and longitudinal prospective observational studies. After screening, 141 studies were included in our review. A large number of reviewed articles were allocated to HFrEF and CAD, suggesting IVA as an alternative to β-blockers in case of contraindications or intolerance. The beneficial effects of IVA as premedication for coronary computed tomography angiography, HR lowering in POTS, and inappropriate sinus tachycardia constituted most studies among off-label uses. Promising results have been reported on the efficacy of IVA in controlling HR, especially in patients with inappropriate sinus tachycardia or POTS. Due to the unique mechanism of action, IVA has the potential to be used more frequently in future clinical practice.

心率（HR）是心血管疾病的预后指标，也是心力衰竭（HF）的一个可改变的风险因素。药物不耐受会限制传统的降低心率β受体阻滞剂达到最佳目标剂量。伊伐布雷定（IVA）是一种特异性负性节律调节剂，可选择性地抑制中房结起搏细胞中的If电流，而不会抑制心肌收缩力或影响血液动力学。本综述总结了伊伐布雷定的临床标示和非标示用途以及作用机制，重点关注临床结果。以IVA、冠状动脉疾病（CAD）、高血压、体位性正位性心动过速综合征（POTS）和快速性心律失常为关键词，检索了截至2024年1月的PubMed。为了全面回顾IVA的临床适应症、机制和治疗效果，研究人员纳入了所有研究IVA治疗人类的研究，包括随机对照试验（RCT）和纵向前瞻性观察研究等不同类型的研究。经过筛选，141 项研究被纳入我们的综述。大量的综述文章被分配给高房颤和冠状动脉粥样硬化，这表明在有禁忌症或不耐受的情况下，IVA可作为β受体阻滞剂的替代药物。IVA作为冠状动脉计算机断层扫描血管造影术前用药、降低POTS患者的心率和不适当的窦性心动过速的有益效果，是标示外使用中的大多数研究。关于 IVA 控制心率的疗效，特别是对不适当窦性心动过速或 POTS 患者的疗效，已有令人鼓舞的结果报道。由于其独特的作用机制，IVA 有可能在未来的临床实践中得到更广泛的应用。

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引用次数: 0

Low-intensity heparin infusion compared to high-intensity heparin infusion dosing in patients with mechanical mitral valves: a retrospective cohort study 机械性二尖瓣患者低强度肝素输注与高强度肝素输注剂量的比较：一项回顾性队列研究

IF 2.6 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Pharmacology

Pub Date : 2024-07-02 DOI: 10.1097/fjc.0000000000001608

Megumi Olsen, Sarah Adie, Alyssa Divens, Kayla Popova, Adamo Brancaccio

Patients with a mechanical mitral valve have an increased risk of thrombosis, and guidelines recommend a higher international normalized ratio (INR) goal for vitamin K antagonists (VKA) based anticoagulation. Guidelines provide recommendations for bridging with unfractionated heparin; however, there is no clear guidance on the heparin infusion intensity that should be utilized. This study was a retrospective, single-center, cohort study of patients aged ≥ 18 years of age or older with a mechanical mitral valve admitted from June 2019 to September 2022 who were maintained on a singular heparin infusion intensity nomogram for at least 48 hours. The patients were stratified into either a low- or high-intensity heparin infusion nomogram. The exclusion criteria included non-nomogram heparin infusions and patients within 30 days of valve implantation. The primary outcome of this study was a composite of all bleeding events (major, clinically significant non-major, and minor bleeding). The secondary outcomes included bleeding events, analyzed individually, and thrombotic events. Seven total bleeding events were observed between the two groups, with one minor bleeding event in the low-intensity group and six bleeding events in the high-intensity group. One thrombotic event occurred in the high-intensity group. No statistically significant differences were found between the primary and secondary outcomes. Future studies are necessary to guide heparin infusion intensity selection in patients with mechanical mitral valves.

患有机械性二尖瓣的患者血栓形成的风险会增加，因此指南建议在使用维生素 K 拮抗剂 (VKA) 抗凝时应提高国际标准化比值 (INR) 目标。指南建议使用非分数肝素进行桥接，但对于应使用的肝素输注强度没有明确的指导。本研究是一项回顾性、单中心、队列研究，研究对象为 2019 年 6 月至 2022 年 9 月期间收治的年龄≥ 18 岁或以上、患有机械二尖瓣的患者，这些患者在单个肝素输注强度提名图上至少维持了 48 小时。患者被分为低强度或高强度肝素输注提名图。排除标准包括未按提名图输注肝素和瓣膜植入术后 30 天内的患者。本研究的主要结果是所有出血事件（大出血、有临床意义的非大出血和小出血）的综合结果。次要结果包括出血事件（单独分析）和血栓事件。两组共观察到 7 起出血事件，其中低强度组有 1 起轻微出血事件，高强度组有 6 起出血事件。高强度组发生了一起血栓事件。主要结果和次要结果之间没有统计学意义上的差异。今后有必要开展研究，为机械二尖瓣患者选择肝素输注强度提供指导。

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引用次数: 0

Upregulation of Angiomotin-like 2 ameliorates experimental pulmonary arterial hypertension by inactivating YAP1 signaling 通过使 YAP1 信号失活，上调 Angiomotin-like 2 可改善实验性肺动脉高压症状

IF 2.6 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Pharmacology

Pub Date : 2024-07-02 DOI: 10.1097/fjc.0000000000001606

Jizhao Deng, Guang Yang, Nier Zhong, Lei Liang, Hai-chao Chen

Angiomotin-like 2 (AMOTL2) is related to numerous physiological and pathological conditions by affecting signal transduction. However, whether AMOTL2 is linked to pulmonary arterial hypertension (PAH) has not been addressed. This work aimed to investigate the potential role of AMOTL2 in PAH. A decrease in AMOTL2 abundance was observed in the lungs of PAH rats. The upregulation of AMOTL2 significantly decreased right ventricle systolic pressure and right ventricular hypertrophy in PAH rats. Overexpression of AMOTL2 also led to a noteworthy decrease in vascular wall thickness, pulmonary artery area, and collagen deposition in rats with PAH. AMOTL2 was downregulated in hypoxia-stimulated pulmonary arterial smooth muscle cells (PASMCs). Moreover, AMOTL2 overexpression impeded hypoxia-evoked proliferation, migration and phenotypic transformation in rat PASMCs. Mechanistic investigation revealed that Yes-associated protein 1 (YAP1) activation in PAH rats or hypoxia-stimulated PASMCs was markedly inhibited by AMOTL2 overexpression, which was associated with increased large tumor suppressor 1/2 (LATS1/2) phosphorylation. The inhibition of LATS1/2 reversed the AMOTL2-mediated inactivation of YAP1. Restoring the activity of YAP1 reversed the inhibitory effect of AMOTL2 on hypoxia-evoked proliferation, migration and phenotypic transformation of PASMCs. Collectively, these results suggest that AMOTL2 can ameliorate PAH in a rat model by interfering with pulmonary arterial remodeling via the inactivation of YAP1 signaling. Our work indicates that AMOTL2 may be a candidate target for novel drug development for the treatment of PAH.

血管紧张素样 2（AMOTL2）通过影响信号转导与许多生理和病理情况有关。然而，AMOTL2是否与肺动脉高压（PAH）有关尚未得到研究。这项工作旨在研究 AMOTL2 在 PAH 中的潜在作用。在 PAH 大鼠肺部观察到 AMOTL2 丰度下降。AMOTL2 的上调可显著降低 PAH 大鼠的右心室收缩压和右心室肥大。过表达 AMOTL2 还导致 PAH 大鼠血管壁厚度、肺动脉面积和胶原沉积明显减少。在低氧刺激的肺动脉平滑肌细胞（PASMCs）中，AMOTL2 被下调。此外，过表达 AMOTL2 会阻碍缺氧诱导的大鼠肺动脉平滑肌细胞的增殖、迁移和表型转化。机理研究发现，AMOTL2过表达可明显抑制PAH大鼠或低氧刺激的PASMCs中Yes相关蛋白1（YAP1）的激活，这与大肿瘤抑制因子1/2（LATS1/2）磷酸化增加有关。LATS1/2 的抑制逆转了 AMOTL2 介导的 YAP1 失活。恢复 YAP1 的活性可逆转 AMOTL2 对缺氧诱导的 PASMCs 增殖、迁移和表型转化的抑制作用。总之，这些结果表明，AMOTL2 可通过使 YAP1 信号失活来干扰肺动脉重塑，从而改善大鼠模型中的 PAH。我们的研究表明，AMOTL2 可能是开发治疗 PAH 新药的候选靶点。

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引用次数: 0

A Potential Role for Pharmacologic Phosphodiesterase 5 Inhibitors in the Treatment of Obstructive Sleep Apnea. 药理磷酸二酯酶 5 抑制剂在治疗阻塞性睡眠呼吸暂停中的潜在作用。

IF 2.6 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Pharmacology

Pub Date : 2024-07-01 DOI: 10.1097/FJC.0000000000001527

Lisa A Gottlieb

引用次数: 0

Use of 3D Echocardiography Facilitates Analysis of Thrombolytic Efficacy in Patients With Persistent Atrial Fibrillation. 使用三维超声心动图有助于分析持续性心房颤动患者的溶栓疗效。

IF 2.6 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Pharmacology

Pub Date : 2024-07-01 DOI: 10.1097/FJC.0000000000001567

Yin Feng Chen, Nan Nan Liu, Jing Yun Wang, Jing Shu Sun, Yi Xiao Wang, Hai Ying Jiang, Wei Wei Zhou, Zu Lu Wang, Ming Liang

Abstract: This study seeks to identify the anticoagulant efficacy of rivaroxaban treatment on thrombi detected using echocardiography of the left atrial appendage in 275 patients with persistent atrial fibrillation. During follow-up after 9-24 weeks of rivaroxaban treatment, patients were divided into "effective group" (n = 143) and "ineffective group" (n = 132) according to the thrombolytic effect of the drug. Left atrial diameter (LAD), left atrial ejection fraction (LAEF), left ventricular ejection fraction (LVEF), mean diameter of left atrial appendage (LAAD mean ), angle between left atrial appendage and left atrium (LAA-A), velocity of blood flow in left atrial appendage (LAA-v), and thrombus size were compared before and after drug administration. Following treatment, LAEF, LVEF, and LAA-v values were greater and LAD and LAAD mean values were lower in the effective ( P < 0.05). Logistic regression analysis showed significant correlations of LAD, LAEF, LVEF, LAA-A, and LAA-v with anticoagulant efficacy ( P < 0.05). The efficacy of rivaroxaban in treatment of left atrial auricular thrombosis in patients with persistent AF was correlated with LAD, LAEF, LVEF, LAA-A, and LAA-v. Multivariate logistic regression analysis further revealed LAEF [odds ratio (OR) 1.7, 95% confidence interval (CI), 0.45-16.9, P = 0.008], 3D-EF (OR 6.4, 95% CI, 1.06-16.9, P = 0.039) and left ventricular global longitudinal strain (OR 18.0, 95% CI, 1.38-35.68, P = 0.028) as factors related to left atrial appendage thrombus. Echocardiography with global longitudinal strain assessment could be effectively utilized to evaluate the functional parameters of LAA and thus aid in predicting the safety of rivaroxaban as an anticoagulation agent.

摘要：本研究旨在确定利伐沙班治疗对275例持续性心房颤动（房颤）患者左心房阑尾超声心动图检测到的血栓的抗凝疗效。在利伐沙班治疗9至24周后的随访期间，根据药物的溶栓效果将患者分为 "有效组"（143人）和 "无效组"（132人）。比较用药前后左心房直径（LAD）、左心房射血分数（LAEF）、左心室射血分数（LVEF）、左心房阑尾平均直径（LAADmean）、左心房阑尾与左心房夹角（LAA-A）、左心房阑尾血流速度（LAA-v）和血栓大小。治疗后，有效者的 LAEF、LVEF 和 LAA-v 值更高，LAD 和 LAADmean 值更低（P＜0.05）。

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引用次数: 0

Comparative Effectiveness and Safety of Intermittent, Repeated, or Continuous Use of Levosimendan, Milrinone, or Dobutamine in Patients With Advanced Heart Failure: A Network and Single-Arm Meta-analysis. 晚期心力衰竭患者间歇、重复或持续使用左西孟旦、米力农或多巴酚丁胺的有效性和安全性比较：一项网络和单臂荟萃分析。

IF 2.6 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Pharmacology

Pub Date : 2024-07-01 DOI: 10.1097/FJC.0000000000001561

Xue Zhang, Zhongsu Wang, Le Zhang, Xia Zhao, Yi Han

Abstract: The aim of this study was to synthesize the available evidence regarding differences in the long-term safety and efficacy of intermittent, repeated, or continuous palliative inotropic therapy among patients with advanced heart failure. We systematically searched the PubMed, Embase, and Cochrane Library electronic databases, with a cutoff date of November 23, 2023, for studies reporting outcomes in adult patients with advanced heart failure treated with intermittent, repeated, or continuous levosimendan, milrinone, or dobutamine. Forty-one studies (18 randomized controlled trials and 23 cohort studies) comprising 5137 patients met the inclusion criteria. The results of the network meta-analysis of randomized controlled trials showed that levosimendan had significant advantages over milrinone or dobutamine in reducing mortality and improving left ventricular ejection fraction. A single-arm meta-analysis also indicated that levosimendan had the lowest mortality and significantly improved B-type brain natriuretic peptide and left ventricular ejection fraction. Regarding safety, hypotension events were observed more frequently in the levosimendan and milrinone groups. However, the current evidence is limited by the heterogeneity and relatively small sample size of the studies.

摘要：综述有关晚期心力衰竭（HF）患者间歇性、重复性或持续性姑息性肌力治疗的长期安全性和有效性差异的现有证据。我们系统地检索了 PubMed、Embase 和 Cochrane Library 电子数据库（截止日期为 2023 年 11 月 23 日）中报告晚期心力衰竭成年患者接受间歇、重复或持续左西孟旦、米力农或多巴酚丁胺治疗结果的研究。共有 41 项研究（18 项随机对照试验和 23 项队列研究）、5137 名患者符合纳入标准。随机对照试验的网络荟萃分析结果显示，与米力农或多巴酚丁胺相比，左西孟旦在降低死亡率和改善 LVEF 方面具有显著优势。单臂荟萃分析还表明，左西孟旦的死亡率最低，并能显著改善 BNP 和 LVEF。在安全性方面，左西孟旦组和米力农组出现低血压事件的频率较高。然而，目前的证据因研究的异质性和样本量相对较小而受到限制。

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引用次数: 0

Are We Ready for Expanding the Use of Sodium-Glucose Cotransporter-2 Inhibitors in Patients With Acute Myocardial Infarction? 我们准备好在急性心肌梗死患者中扩大钠-葡萄糖转运体-2 抑制剂的使用范围了吗？

IF 2.6 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Pharmacology

Pub Date : 2024-07-01 DOI: 10.1097/FJC.0000000000001587

Paschalis Karakasis, Dimitrios Patoulias, George Giannakoulas, Nikolaos Fragakis

引用次数: 0