Lima Marcelo Villaça, Ochiai Marcelo E, Vieira Kelly N, Scipioni Airton, Cardoso Juliano N, Munhoz Robinson T, Morgado Paulo C, Barretto Antonio C P
Heart Institute (Instituto do Coração - InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo.
Int Heart J. 2014;55(5):433-9. doi: 10.1536/ihj.14-096. Epub 2014 Jul 28.
Adjunctive and non-pharmacological therapies, such as heat, for the treatment of heart failure patients have been proposed. Positive results have been obtained in clinically stable patients, but no studies of the use of thermal therapy in patients with decompensated heart failure (DHF) have been reported. An open randomized clinical trial was designed in patients with DHF and controls. We studied 38 patients with a mean age of 56.9 years. A total of 86.8% were men, and 71% had nonischemic myocardiopathy. All participants were using dobutamine, and the median brain natriuretic peptide (BNP) level was 1396 pg/mL. An infrared thermal blanket heated the patients, who were divided into 2 groups: group T (thermal therapy) and group C (control). Group T underwent vasodilation using the thermal blanket at 50°C for 40 minutes in addition to drug treatment. The cardiac index increased by 24.1% (P = 0.009), and systemic vascular resistance decreased by 16.0% in group T (P < 0.024) after thermal therapy. Heat as a vasodilator increased the cardiac index and lowered systemic vascular resistance in DHF patients. These data suggest thermal therapy as a therapeutic approach for the adjuvant treatment of DHF patients.
已经有人提出采用辅助性和非药物疗法,如热敷,来治疗心力衰竭患者。在临床稳定的患者中已取得了积极成果,但尚未有关于在失代偿性心力衰竭(DHF)患者中使用热疗的研究报告。我们针对DHF患者和对照组设计了一项开放性随机临床试验。我们研究了38名平均年龄为56.9岁的患者。其中86.8%为男性,71%患有非缺血性心肌病。所有参与者均在使用多巴酚丁胺,脑钠肽(BNP)水平的中位数为1396 pg/mL。使用红外热毯对患者进行加热,患者被分为两组:T组(热疗组)和C组(对照组)。T组除药物治疗外,还使用热毯在50°C下进行40分钟的血管扩张治疗。热疗后,T组的心脏指数增加了24.1%(P = 0.009),全身血管阻力降低了16.0%(P < 0.024)。热作为一种血管扩张剂,可增加DHF患者的心脏指数并降低全身血管阻力。这些数据表明热疗可作为DHF患者辅助治疗的一种方法。