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钠-心力衰竭试验中饮食干预的设计及区域特异性调整:一项多中心研究

Design and Region-Specific Adaptation of the Dietary Intervention Used in the SODIUM-HF Trial: A Multicentre Study.

作者信息

Colin-Ramirez Eloisa, Arcand JoAnne, Woo Elizabeth, Brum Margaret, Morgan Kate, Christopher Winnie, Velázquez Lubia, Sharifzad Amirhossein, Feeney Sinead, Ezekowitz Justin A

机构信息

National Council of Science and Technology (CONACYT), and National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico.

Canadian VIGOUR Centre, University of Alberta, Edmonton, Alberta, Canada.

出版信息

CJC Open. 2019 Dec 7;2(1):8-14. doi: 10.1016/j.cjco.2019.11.006. eCollection 2020 Jan.

Abstract

BACKGROUND

Restricting dietary sodium consumption has been considered a major component of self-care management in heart failure (HF); however, the evidence supporting this recommendation has not been conclusive. The tudy f ietary ntervention nder 100 MOL in eart ailure (SODIUM-HF) trial aims to assess the effects of dietary sodium reduction on clinical outcomes in a HF population using a pragmatic design to provide empirical evidence to guide dietary sodium intake recommendations in patients with chronic HF.

METHODS

SODIUM-HF is a multicentre, open-label, blinded adjudicated endpoint, randomized controlled trial in ambulatory patients with chronic HF. This trial involves participants recruited from sites in Canada, Australia, New Zealand, Mexico, Colombia, and Chile, who are followed up to 24 months. Rationale and methods of the SODIUM-HF trial were published elsewhere. As an international pragmatic dietary trial, SODIUM-HF was designed to address several challenges, such as defining the most suitable intervention to account for country-specific variations in food intake and availability. In SODIUM-HF, we implemented the Nutrition-Care Model to provide a comprehensive intervention delivered directly to patients, focusing on modifying the nutrient composition of the diet (sodium restriction), using a personalized counselling and close follow-up.

RESULTS

Available upon completion of the trial.

CONCLUSIONS

This long-term dietary trial is one of the first in its type in the HF field. This article describes in detail the rationale and methods for the dietary intervention employed and the region-specific adaptation of the SODIUM-HF intervention, so that the learning and processes taken in this trial can be applied to future multicountry dietary clinical trials.

摘要

背景

限制饮食中钠的摄入量一直被视为心力衰竭(HF)自我护理管理的主要组成部分;然而,支持这一建议的证据并不确凿。心力衰竭100 mmol以下饮食干预研究(SODIUM-HF)试验旨在通过实用设计评估饮食中钠减少对心力衰竭患者临床结局的影响,以提供实证依据来指导慢性心力衰竭患者的饮食钠摄入量建议。

方法

SODIUM-HF是一项针对慢性心力衰竭门诊患者的多中心、开放标签、终点判定双盲、随机对照试验。该试验涉及从加拿大、澳大利亚、新西兰、墨西哥、哥伦比亚和智利的研究点招募的参与者,随访时间长达24个月。SODIUM-HF试验的原理和方法已在其他地方发表。作为一项国际实用饮食试验,SODIUM-HF旨在应对多项挑战,例如确定最合适的干预措施,以考虑不同国家食物摄入量和可获得性的差异。在SODIUM-HF试验中,我们采用营养护理模式,直接为患者提供全面干预,重点是通过个性化咨询和密切随访来改变饮食的营养成分(限制钠摄入)。

结果

试验完成后提供。

结论

这项长期饮食试验是心力衰竭领域同类试验中的首批试验之一。本文详细描述了所采用的饮食干预的原理和方法以及SODIUM-HF干预措施的区域适应性,以便本试验中的经验和流程能够应用于未来的多国饮食临床试验。

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本文引用的文献

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Estimates of Dietary Sodium Consumption in Patients With Chronic Heart Failure.慢性心力衰竭患者膳食钠摄入量的评估。
J Card Fail. 2015 Dec;21(12):981-8. doi: 10.1016/j.cardfail.2015.08.345. Epub 2015 Sep 18.

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