Kanorsky S G, Borisenko Y V
Kuban State Medical University, Krasnodar, Russia.
Kardiologiia. 2016 Feb;56(2):24-29. doi: 10.18565/cardio.2016.2.24-29.
Treatment of patients with chronic heart failure (CHF) and preserved left ventricular (LV) ejection fraction remains largely empirical, as none of the methods of therapy improves the prognosis of patients. In a prospective randomized study on 126 patients with CHF and LV ejection fraction more or equal 50% we compared effectiveness of long-term treatment with bisoprolol (n=62) and ivabradine (n=64). Assessment of clinical status, exercise tolerance (ET), quality of life, blood level of N-terminal brain natriuretic peptide precursor, and parameters of echocardiography was performed at baseline and after 12 months of therapy. Unlike bisoprolol ivabradine, significantly improved exercise tolerance, quality of life, and reduced level of N-terminal brain natriuretic peptide precursor. Improvement of echocardiographic indices of active relaxation and compliance of the left ventricle was also observed. Key words: heart failure with preserved ejection fraction; ivabradine; bisoprolol; left ventricle diastolic dysfunction.
对于慢性心力衰竭(CHF)且左心室(LV)射血分数保留的患者,治疗很大程度上仍基于经验,因为没有一种治疗方法能改善患者的预后。在一项针对126例CHF且LV射血分数大于或等于50%患者的前瞻性随机研究中,我们比较了比索洛尔(n = 62)和伊伐布雷定(n = 64)长期治疗的有效性。在基线和治疗12个月后,对临床状态、运动耐量(ET)、生活质量、N末端脑钠肽前体的血药浓度以及超声心动图参数进行了评估。与比索洛尔不同,伊伐布雷定显著改善了运动耐量、生活质量,并降低了N末端脑钠肽前体水平。还观察到左心室主动舒张和顺应性的超声心动图指标有所改善。关键词:射血分数保留的心力衰竭;伊伐布雷定;比索洛尔;左心室舒张功能障碍