■心脏重塑是与心力衰竭(HF)进展相关的不利现象。心脏重塑可以代表治疗HF和射血分数降低(HFrEF)患者的真正治疗目标,可能通过不同的药物治疗逆转。目前,有公认的药物如ACEi/ARBs和β受体阻滞剂具有抗重塑作用。最近,还证明了ARNI对心脏重塑的影响;格利福净的其他潜在益处仍未明确证明。
评估使用ARNI或ARNI加SGLT2i治疗HFrEF/HFmrEF患者心脏重塑的可能变化,以及在ARNI中加入SGLT2i对心脏重塑的潜在益处。
■在2021年6月至2023年8月之间,连续100例HFrEF/HFmrEF患者接受了常规和高级超声心动图检查(TDI,2DSTE):因此,根据既不使用ARNI也不使用SGLT2i的治疗将患者分为三组,只有ARNI或两者兼而有之。三个月后,所有患者均接受超声心动图随访.
■经过3个月的治疗,LVEF显著改善,LVEDD,LVEDV,LVESV,低压质量,E/E\',LVGLS,TAPSE(所有情况下的方差分析p<0.01),RVS'速度(方差分析p<0.001)。即使在多变量分析后,支持SGTL2i而不是ARNI的额外治疗的趋势仍然具有统计学意义(LVEF的p<0.001,LVEDD;LVGLS的p<0.01,TAPSE,TRVS;对于LV质量,p<0.05)。
■SGLT2i治疗添加到HFrEF和HFmrEF的标准治疗中时,与随访时改善的双心室功能和心室尺寸相关。
UNASSIGNED: Cardiac remodeling is an adverse phenomenon linked to heart failure (HF) progression. Cardiac remodeling could represent the real therapeutic goal in the treatment of patients with HF and reduced ejection fraction (HFrEF), being potentially reversed through different pharmacotherapies. Currently, there are well-established drugs such as ACEi/ARBs and β-blockers with anti-remodeling effects. More recently, ARNI effects on cardiac remodeling were also demonstrated; additional potential benefits of gliflozins remain non clearly demonstrated.
UNASSIGNED: To evaluate possible changes in cardiac remodeling in patients with HFrEF/HFmrEF in treatment with ARNI or ARNI plus
SGLT2i and the potential benefit on cardiac remodeling of adding
SGLT2i to ARNI.
UNASSIGNED: Between June 2021 and August 2023, 100 consecutive patients with HFrEF/HFmrEF underwent conventional and advanced echocardiography (TDI, 2DSTE): patients were therefore divided into three groups according to therapy with neither ARNI nor
SGLT2i, just ARNI or both. After 3 months, all patients underwent echocardiographic follow-up.
UNASSIGNED: After a 3 months of therapy, significant improvements were observed for LVEF, LVEDD, LVEDV, LVESV, LV mass, E/e\', LV GLS, TAPSE (ANOVA p< 0.01 in all cases), RV S\' velocity (ANOVA p< 0.001).The trend in favor of additional treatment with SGTL2i over ARNI remained statistically significant even after multivariable analysis (p< 0.001 for LVEF, LVEDD; p< 0.01 for LV GLS, TAPSE, TRVS; p< 0.05 for LV mass).
UNASSIGNED: SGLT2i therapy when added to the standard treatment for HFrEF and HFmrEF is associated with an improved biventricular function and ventricular dimensions at follow-up.