...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Journal of cardiac failure >New insights into mechanisms of action of carvedilol treatment in chronic heart failure patients - A matter of time for contractility
【24h】

New insights into mechanisms of action of carvedilol treatment in chronic heart failure patients - A matter of time for contractility

机译：卡维地洛治疗慢性心力衰竭患者的作用机理的新见解-收缩的时间问题

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Background: It is unclear whether improvement in left ventricular (LV) ejection fraction (LVEF) following treatment with a combined α 1,β 1,β 2-blockade can be attributed to improvement in LV contractility, to a reduction in afterload, and/or to improvements in LV remodeling and chamber size. We aimed to examine whether the observed improvement in LVEF following carvedilol treatment is due to changes in intrinsic myocardial contractility beyond changes in LV chamber size or loading conditions. Methods and Results: In 49 consecutive patients with chronic heart failure (HF), LVEF ≤35%, NYHA functional class II-IV, on angiotensin-converting enzyme inhibitors but not on ?-blockers, LV contractile performance and remodeling were assessed by comprehensive echocardiography at baseline and after 3 and 6 months of treatment with carvedilol. Carvedilol treatment resulted in significant improvements in LVEF, shortening fraction, and velocity of circumferential shortening (VCF c). There were no significant changes in the mean arterial blood pressure or systemic vascular resistance index; but LV end-systolic wall stress (LVESS), effective arterial elastance, ventriculoarterial coupling, and LV end-diastolic and end-systolic dimensions and volumes were significantly reduced. Estimated end-systolic elastance, VCF c-to-LVESS ratio, and pulsatile arterial compliance significantly improved after 6 months of treatment with carvedilol. The slope of the VCF c relationship to LVESS worsened from 0 to 3 months, but significantly improved from 3 to 6 months. Conclusions: Despite an initial transient negative inotropic effect from 0 to 3 months, carvedilol treatment was associated with a positive inotropic effect with significant improvement in load-independent indexes of myocardial contractility beyond what can be attributed to changes in LV chamber size and load after 3 months. There were no changes in systemic vascular resistance with carvedilol treatment; however, improvement in pulsatile arterial compliance and ventriculoarterial coupling suggested enhanced cardiac mechanoenergetic performance along with improved systemic arterial compliance.
机译：背景：目前尚不清楚α1，β1，β2联合治疗后左心室射血分数（LVEF）的改善是否可归因于左室收缩力的改善，后负荷的降低和/或改善左室重塑和腔室大小。我们的目的是检查观察到的卡维地洛治疗后左室射血分数的改善是否是由于内在心肌收缩力的改变所致，而不是左室大小或负荷条件的改变。方法和结果：连续49例慢性心力衰竭（HF），LVEF≤35％，NYHA功能II-IV级，使用血管紧张素转化酶抑制剂但未使用β-受体阻滞剂的患者，通过综合评估左室收缩性能和重塑基线时以及卡维地洛治疗3个月和6个月后进行超声心动图检查。卡维地洛治疗导致LVEF，缩短分数和圆周缩短速度（VCF c）显着改善。平均动脉血压或全身血管阻力指数无明显变化。但LV收缩末期壁应力（LVESS），有效动脉弹性，心室动脉耦合以及LV舒张末期和收缩末期的尺寸和体积均明显减少。卡维地洛治疗6个月后，估计的收缩末期弹性，VCF c-LVESS比和搏动性动脉顺应性显着改善。 VCF c与LVESS的关系斜率从0到3个月恶化，但从3到6个月显着改善。结论：尽管最初的暂时性负性肌力作用从0到3个月，卡维地洛治疗仍具有正性正性肌力作用，其心肌收缩力独立于负荷的指标显着改善，超过了3周后左室大小和负荷的变化。几个月。卡维地洛治疗后全身血管阻力无变化;然而，搏动性动脉顺应性和心室-动脉耦合的改善表明，心脏机械能性能增强，而全身性动脉顺应性也得到改善。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号