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JACC:Ivabradine可有效改善体位性直立性心动过速综合征患者的心率和生活质量

2021-03-02 MedSci原创 MedSci原创

体位性直立性心动过速综合征(POTS)是一种复杂的、多因素疾病,会损害功能状态和生活质量。目前可用的治疗药物有限,Ivabradine是否可有效治疗POTS?

体位性直立性心动过速综合征(POTS)是一种复杂的、多因素疾病,会损害功能状态和生活质量。目前可用的治疗药物有限。

本研究旨在探讨选择性窦房结Ifunny通道阻滞剂伊伐布雷定(ivabradine)对血浆去甲肾上腺素(NE)>600pg/ml和倾斜试验异常的高肾上腺素能POTS患者心率、生活质量(QOL)和血浆NE水平的影响。

这是一项随机、双盲、安慰剂为对照的伊伐布雷定交叉试验,共22例以高肾上腺素能POTS为主要亚型的患者完成了该试验。随机分组后患者接受伊伐布雷定或安慰剂治疗1个月,然后交叉使用另一种治疗1个月。在基线和每个治疗月末测量心率、生活质量和血浆NE水平。

伊伐布雷定对心率的影响

受试患者平均年龄为 33.9±11.7岁,女性占95.5%(n=21),白人占86.4%(n=23)。与安慰剂组相比,伊伐布雷定组患者的心率明显减慢(P<0.001)。

伊伐布雷定对生活质量的影响(SF-36)

通过RAND 36项身体功能和社会功能健康调查1.0,患者报告的的生活质量都有了显著的改善。服用伊伐布雷定后,NE水平有明显下降趋势(p=0.056),且没有出现任何明显的副作用,如心动过缓或低血压。

综上,伊伐布雷定能明显改善以高肾上腺素能POTS为主要亚型的患者的心率和生活质量,是一种安全有效的治疗方法

原始出处:

Taub Pam R,Zadourian Adena,Lo Hannah C et al. Randomized Trial of Ivabradine in Patients With Hyperadrenergic Postural Orthostatic Tachycardia Syndrome. J Am Coll Cardiol, 2021, 77: 861-871.

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    2021-05-26 hbwxf
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    2021-06-27 ms6000000535834193

    很有用

    0

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    2021-03-04 zhouqu_8
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