Dipartimento Biomedico di Medicina Interna e Specialistica, Università degli Studi di Palermo, p.zza delle Cliniche n.2, 90127 Palermo, Italy.
Nutr Metab Cardiovasc Dis. 2011 May;21(5):372-9. doi: 10.1016/j.numecd.2009.10.014. Epub 2010 Mar 25.
Neurohormonal activation and inflammation characterizes heart failure, relates to outcome, and is a therapeutic target. The aim of this study was to evaluate the effects of high-dose furosemide plus small-volume hypertonic saline solutions (HSS) on natriuretic peptides and immuno-inflammatory marker levels and to analyze, after treatment, the response to acute saline loading.
120 patients with heart failure treated with high-dose furosemide+HSS (Furosemide/HSS group) were matched with: 30 subjects with heart failure treated with high-dose furosemide (furosemide group), 30 controls with asymptomatic left-ventricular dysfunction (ALVD) (asymptomatic group) and 30 controls without heart failure or ALVD (Healthy group). We evaluated plasma levels of natriuretic peptides and cytokine levels in baseline, after treatment and after acute saline load. After treatment with high-dose furosemide+HSS compared to treatment with furosemide alone we observed a significant lowering of ANP [96 (46.5-159.5) pg/ml vs 64 (21-150) pg/ml], BNP [215.5 (80.5-487) pg/ml vs 87 (66-141.5) pg/ml], TNF-α [389.5 (265-615.5) pg/ml vs 231.5 (156-373.5) pg/ml], IL-1β [8 (7-9) pg/ml vs 4 (3-7) pg/ml], IL-6 [5 (3-7.5) pg/ml vs 3 (2-4) pg/ml], plasma values and after an acute saline load, a lower percentage change of ANP (+18.6% vs +28.03% vs +25% vs +29%), BNP (+14.5% vs +29.2% vs +30% vs +29.6%) TNF-α (+10.8% vs +15.8% vs +17.8% vs +11.3%), IL-1β (+20% vs 34.4% vs 40% vs 34.4%) compared to control groups.
Treatment with HSS could be responsible for a stretching relief that could influence natriuretic and immuno-inflammatory markers.
神经激素激活和炎症是心力衰竭的特征，与预后相关，也是治疗靶点。本研究的目的是评估大剂量呋塞米联合小容量高渗盐水（HSS）对利钠肽和免疫炎症标志物水平的影响，并在治疗后分析对急性盐水负荷的反应。
120 例心力衰竭患者接受大剂量呋塞米+HSS（呋塞米/HSS 组）治疗，与以下 3 组进行匹配：30 例心力衰竭患者接受大剂量呋塞米（呋塞米组）治疗，30 例无症状左心室功能障碍（ALVD）患者（无症状组）和 30 例无心力衰竭或 ALVD 患者（健康组）。我们在基线、治疗后和急性盐水负荷后评估了血浆利钠肽和细胞因子水平。与单独使用呋塞米相比，大剂量呋塞米+HSS 治疗后，我们观察到 ANP [96（46.5-159.5）pg/ml 比 64（21-150）pg/ml]、BNP [215.5（80.5-487）pg/ml 比 87（66-141.5）pg/ml]、TNF-α [389.5（265-615.5）pg/ml 比 231.5（156-373.5）pg/ml]、IL-1β [8（7-9）pg/ml 比 4（3-7）pg/ml]、IL-6 [5（3-7.5）pg/ml 比 3（2-4）pg/ml]的血浆值降低，且在急性盐水负荷后，ANP [+18.6%比+28.03%比+25%比+29%]、BNP [+14.5%比+29.2%比+30%比+29.6%]、TNF-α [+10.8%比+15.8%比+17.8%比+11.3%]、IL-1β [+20%比 34.4%比 40%比 34.4%]的百分比变化较低。
HSS 治疗可能导致伸展缓解，从而影响利钠肽和免疫炎症标志物。
Zotero 插件