卡维地洛对功能性单心室心力衰竭患者的影响。
Effect of carvedilol on heart failure in patients with a functionally univentricular heart.
机构信息
Department of Pediatrics, Sakakibara Heart Institute, Tokyo, Japan.
出版信息
Circ J. 2011;75(6):1394-9. doi: 10.1253/circj.cj-10-0845. Epub 2011 Mar 22.
BACKGROUND
The effect of carvedilol on heart failure (HF) in patients with a functionally univentricular heart (UVH) remains unclear.
METHODS AND RESULTS
Carvedilol was used to treat HF in 51 patients with a UVH, classified into 3 groups: after the Fontan operation (F), after the bidirectional Glenn operation (G), and patients who had not undergone Fontan or Glenn operation (NF). Carvedilol therapy was started at a mean age of 10 ± 12 years (range: 1 month to 34 years). The initial and maximum doses of carvedilol were 0.04 ± 0.03 and 0.42 ± 0.29 mg · kg(-1) · day(-1), respectively. After a mean follow-up of 11 months, the cardiothoracic ratio improved from 60 ± 8 to 58 ± 8% (P<0.01), and the dosage of furosemide was reduced from 1.4 ± 0.9 to 0.7 ± 0.7 mg · kg(-1) · day(-1) (P < 0.01). The ejection fraction also improved from 35 ± 12 to 40 ± 11% (P < 0.05), and this improvement was prominent in the F group (from 35 ± 15 to 45 ± 9%; P < 0.05). Clinical signs, symptoms, and New York Heart Association functional class also improved.
CONCLUSIONS
Carvedilol may play an important role in treating HF associated with a UVH.
背景
卡维地洛对功能性单心室（UVH）患者心力衰竭（HF）的影响尚不清楚。
方法和结果
51 例 UVH 患者接受卡维地洛治疗 HF，分为 3 组：Fontan 手术后（F 组）、双向 Glenn 手术后（G 组）和未行 Fontan 或 Glenn 手术的患者（NF 组）。卡维地洛治疗开始时的平均年龄为 10±12 岁（范围：1 个月至 34 岁）。卡维地洛的初始和最大剂量分别为 0.04±0.03 和 0.42±0.29mg·kg(-1)·day(-1)。平均随访 11 个月后，心胸比从 60±8%改善至 58±8%（P<0.01），速尿剂量从 1.4±0.9mg·kg(-1)·day(-1)减少至 0.7±0.7mg·kg(-1)·day(-1)（P<0.01）。射血分数也从 35±12%改善至 40±11%（P<0.05），且 F 组改善更显著（从 35±15%改善至 45±9%；P<0.05）。临床症状、体征和纽约心脏协会心功能分级也得到改善。
结论
卡维地洛可能在治疗与 UVH 相关的 HF 中发挥重要作用。
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