Relationship between heart rate and mortality and morbidity in the irbesartan patients with heart failure and preserved systolic function trial (I-Preserve).
在具有心力衰竭和保留收缩功能试验 (I-Preserve) 的厄贝沙坦患者中,心率与死亡率和发病率之间的关系。

摘要

BACKGROUND:Higher heart rate is associated with poorer outcomes in patients with heart failure and reduced ejection fraction (HF-REF). Less is known about the association between heart rate and outcomes in patients with heart failure and preserved ejection fraction (HF-PEF). Therefore, we examined the relationship between heart rate and outcomes in the irbesartan in patients with heart failure and preserved systolic function trial (I-Preserve) in patients with an ejection fraction >45% aged >60 years.
METHODS AND RESULTS:Heart rate was analysed as both a categorical (tertiles) and continuous variable. Patients in sinus rhythm (n = 3271) and atrial fibrillation (n = 696) were analysed separately. The outcomes examined were the primary endpoint of the trial (all-cause death or cardiovascular hospitalization), the composite of cardiovascular death or heart failure hospitalization (and its components) and all-cause death alone. Higher heart rate was associated with a significantly higher risk of all outcomes studied for patients in sinus rhythm, even after adjustment for other prognostic variables, including N-terminal pro-B-type natriuretic peptide. Each standard deviation (12.4 bpm) increase in heart rate was associated with an increase in risk of 13% for cardiovascular death or heart failure hospitalization (P = 0.002). No relationship between heart rate and outcomes was observed for patients in atrial fibrillation. Beta-blocker treatment did not reduce the heart rate-risk relationship.
CONCLUSIONS:In patients with heart failure and preserved ejection fraction, heart rate is in sinus rhythm an independent predictor of adverse clinical outcomes and might be a therapeutic target in this syndrome. Clinical Trial Registration - URL http://www.clinicaltrials.gov. Unique identifier: NCT 0095238.

译文

背景: 高心率与心力衰竭和射血分数降低 (HF-REF) 患者的不良预后相关。关于心力衰竭和射血分数保留的患者的心率和结果之间的关系知之甚少 (HF-PEF)。因此,我们检查了心率与心力衰竭和保留收缩功能试验 (I-Preserve) 患者厄贝沙坦治疗结果之间的关系。在射血分数> 45% 的患者中,年龄> 60 岁。
方法和结果: 心率作为分类 (tertiles) 和连续变量进行分析。分别分析窦性心律 (n = 3271) 和心房颤动 (n = 696) 患者。检查的结果是试验的主要终点 (全因死亡或心血管住院),心血管死亡或心力衰竭住院 (及其组成部分) 的复合以及全因死亡。即使调整了包括 N 末端 b型钠尿肽前体在内的其他预后变量,较高的心率也与窦性心律患者所有研究结果的显著高风险相关。心率的每个标准差 (12.4 bpm) 增加与心血管死亡或心力衰竭住院的风险增加 13% 相关 (P = 0.002)。没有观察到心房颤动患者的心率和结果之间的关系。β 受体阻滞剂治疗没有降低心率-风险关系。
结论: 在射血分数保留的心力衰竭患者中,心率处于窦性心律,是不良临床结果的独立预测因素,可能是该综合征的治疗目标。临床试验注册-URL http://www.clinicaltrials.gov 。唯一标识符: NCT 0095238。

Irbesartan

心血管 血管紧张素II拮抗药 药物
概述  :  

药理及应用是一种有效的、口服活性的选择性血管紧张素II(AT1亚型)拮抗药,使血浆肾素和血管紧张素Ⅱ水平升高,血浆醛固酮水平降低。其活性不需要代谢激活。在无电解质紊乱的患者单独使用推荐剂量的厄贝沙坦时,血清钾不会受到明显影响。用于治疗原发性高血压及合并高血的非胰岛素依赖型型糖尿病肾病的治疗。口服给药后吸收良好,其绝对生物利用度为60%-80%,进食不会明显影响其生物利用度。血浆蛋白结合率大约96%,在肝与葡糖醛酸结合氧化而被代谢。口服后1.5-2h可达血浆峰浓度。终末清除半衰期为11-15h,厄

Irbesartan

释义   厄贝沙坦

例句   To observe the effect of Irbesartan on hypertension patients with paroxysmal atrialfibrillation and left atrial size. 

观察厄贝沙坦对原发性高血压患者阵发性心房颤动及左心房大小的影响。


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