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阿托伐他汀治疗与心力衰竭患者N末端前体脑利钠肽水平降低及心脏功能改善相关。

Atorvastatin therapy is associated with reduced levels of N-terminal prohormone brain natriuretic peptide and improved cardiac function in patients with heart failure.

作者信息

Stypmann Jörg, Schubert Aurelien, Welp Henryk, Schulte Helmut, Assmann Gerd, Breithardt Günter, Nofer Jerzy-Roch

机构信息

Department of Cardiology and Angiology, Leibniz-Institute for Arteriosclerosis Research, University of Munster, Muster, Germany.

出版信息

Clin Cardiol. 2008 Oct;31(10):478-81. doi: 10.1002/clc.20273.

Abstract

BACKGROUND

Statins have been suggested to improve cardiac function, but the evidence underlying beneficial effects of statins in heart failure (HF) is insufficient. We analyzed plasma N-terminal prohormone brain natriuretic peptide (NT-proBNP) levels and cardiac function in patients with HF of various etiologies, and who were treated with or without statins.

HYPOTHESIS

Statin treatment is associated with improved cardiac function in HF.

METHODS

The study cohort consisted of 139 consecutive male patients receiving atorvastatin (n = 44), simvastatin (n = 29), pravastatin (n = 19), or no statin (n = 47). The NT-proBNP levels were measured using electroluminescence immunoassay. Left ventricular end-diastolic diameter (LVEDD), fractional shortening (FS), and ejection fraction (EF) were determined by echocardiography.

RESULTS

Patients receiving atorvastatin presented with reduced NT-proBNP levels (1,552 +/- 3,416 versus 3,771 +/- 6,763 pg/mL; p < 0.01), and improved values of LVEDD (65.2 +/- 8.9 versus 70.7 +/- 10.9 mm; p < 0.05) and EF (33.2 +/- 12.6 versus 28.2 +/- 9.6%; p < 0.05). By contrast, plasma NT-proBNP and cardiac parameters in patients treated with statins other than atorvastatin did not significantly differ from control. Atorvastatin treatment was equally effective in patients with ischemic and nonischemic HF.

CONCLUSIONS

Atorvastatin treatment is associated with improved cardiac function in HF, and may represent an additional option for patients with this disease.

摘要

背景

他汀类药物已被认为可改善心脏功能,但他汀类药物对心力衰竭(HF)有益作用的证据不足。我们分析了各种病因的HF患者在接受或未接受他汀类药物治疗时的血浆N末端前脑钠肽(NT-proBNP)水平和心脏功能。

假设

他汀类药物治疗与HF患者心脏功能改善相关。

方法

研究队列由139例连续的男性患者组成,其中44例接受阿托伐他汀治疗,29例接受辛伐他汀治疗,19例接受普伐他汀治疗,47例未接受他汀类药物治疗。采用电化学发光免疫分析法测定NT-proBNP水平。通过超声心动图测定左心室舒张末期内径(LVEDD)、缩短分数(FS)和射血分数(EF)。

结果

接受阿托伐他汀治疗的患者NT-proBNP水平降低(1,552±3,416对3,771±6,763 pg/mL;p<0.01),LVEDD(65.2±8.9对70.7±10.9 mm;p<0.05)和EF(33.2±12.6对28.2±9.6%;p<0.05)值改善。相比之下,接受阿托伐他汀以外他汀类药物治疗的患者血浆NT-proBNP和心脏参数与对照组无显著差异。阿托伐他汀治疗对缺血性和非缺血性HF患者同样有效。

结论

阿托伐他汀治疗与HF患者心脏功能改善相关,并可能为此类疾病患者提供额外的治疗选择。

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The pleiotropic effects of statins.他汀类药物的多效性作用。
Curr Opin Cardiol. 2005 Nov;20(6):541-6. doi: 10.1097/01.hco.0000181482.99067.bf.

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