PDF(Pubmed)
Abstract：
Background: Chronic inflammation is a constant phenomenon which accompanies the heart failure pathophysiology. In all phenotypes of heart failure, irrespective of the ejection fraction, there is a permanent low-grade activation and synthesis of proinflammatory cytokines. Many classes of anti-remodelling medication used in the treatment of chronic heart failure have been postulated to have an anti-inflammatory effect. Methods: This retrospective study enrolled 220 patients and focused on evaluating the effect of the most used active substances from these classes in reducing the level of inflammatory biomarkers (C reactive protein, erythrocyte sedimentation rate and fibrinogen) after initiation or up-titration. Our research is evaluating if this anti-inflammatory effect intensifies while raising the dose. The evaluation was performed at two visits with an interval between them of 6 months. Results: From the beta-blockers class, carvedilol showed a reduction in erythrocyte sedimentation rate (ESR), in low (6.25 mg, bi daily) and medium (12.5 mg, bi daily) doses. At the same time, sacubitril/valsartan showed a reduction in CRP levels. This effect was obtained only in the medium (49/51 mg, bi daily) and high (97/103 mg, bi daily) doses, with the maximum reduction being observed in the high dose. Conclusions: From the classes of medication evaluated, the study showed a significant reduction in ESR levels in the low and medium doses of carvedilol and a reduction in CRP values in the cases of medium and high doses of ARNI.
摘要：
背景：慢性炎症是伴随心力衰竭病理生理的一种持续现象。在所有的心力衰竭表型中，不管射血分数，有一个永久性的低级激活和促炎细胞因子的合成。已经假定用于治疗慢性心力衰竭的许多种类的抗重塑药物具有抗炎作用。方法：这项回顾性研究纳入了220例患者，重点评估了这些类别中最常用的活性物质在降低炎症生物标志物（C反应蛋白，开始或向上滴定后的红细胞沉降率和纤维蛋白原）。我们的研究正在评估这种抗炎作用在增加剂量时是否会加剧。在两次访问中进行评估，间隔为6个月。结果：从β受体阻滞剂类别，卡维地洛显示红细胞沉降率（ESR）降低，低（6.25毫克，bidaily)andmedium(12.5mg,每日两次）剂量。同时,沙库巴曲/缬沙坦显示CRP水平降低.仅在培养基（49/51mg，bidaily)andhigh(97/103mg,每日两次)剂量，在高剂量中观察到最大减少。结论：从评估的药物类别来看，该研究表明,低剂量和中剂量卡维地洛的ESR水平显著降低,中剂量和高剂量ARNI的CRP值显著降低.
