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利拉鲁肽治疗慢性心力衰竭患者的心率增加:与临床参数和不良事件的关系。

Heart rate increases in liraglutide treated chronic heart failure patients: association with clinical parameters and adverse events.

机构信息

Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.

Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.

出版信息

Scand Cardiovasc J. 2020 Oct;54(5):294-299. doi: 10.1080/14017431.2020.1751873. Epub 2020 Apr 15.

DOI:10.1080/14017431.2020.1751873
PMID:32292074
Abstract

. Liraglutide, a glucagon-like peptide-1 agonist, is used for treatment of type 2 diabetes and has beneficial cardiovascular properties. However, treatment increases heart rate (HR) and possibly the risk of cardiovascular events in chronic heart failure (CHF) patients. We investigated potential associations between HR changes and clinical, laboratory and echocardiographic parameters and clinical events in liraglutide treated CHF patients. . This was a sub-study of the LIVE study. CHF patients ( = 241) with a left ventricular ejection fraction ≤45% were randomised to 1.8 mg liraglutide daily or placebo for 24 weeks. Electrocardiograms ( = 117) and readouts from cardiac implanted electronic devices ( = 20) were analysed for HR and arrhythmias. . In patients with sinus rhythm (SR), liraglutide increased HR by 8 ± 9 bpm (pulse measurements), 9 ± 9 bpm (ECG measurements) and 9 ± 6 bpm (device readouts) versus placebo (all <.005). Increases in HR correlated with liraglutide dose (=.01). HR remained unchanged in patients without SR. Serious cardiac adverse events were not associated with HR changes. . During 6 months of treatment, HR increased substantially in CHF patients with SR treated with liraglutide but was not associated with adverse events. The long-term clinical significance of increased HR in liraglutide treated CHF patients needs to be determined.

摘要

利拉鲁肽是一种胰高血糖素样肽-1 激动剂,用于治疗 2 型糖尿病,具有有益的心血管特性。然而,在慢性心力衰竭(CHF)患者中,治疗会增加心率(HR)并可能增加心血管事件的风险。我们研究了利拉鲁肽治疗的 CHF 患者中 HR 变化与临床、实验室和超声心动图参数以及临床事件之间的潜在关联。这是 LIVE 研究的一项子研究。将左心室射血分数≤45%的 CHF 患者( = 241)随机分为 1.8 mg 利拉鲁肽每日组或安慰剂组,治疗 24 周。分析了心电图( = 117)和心脏植入式电子设备的读数( = 20)以评估 HR 和心律失常。在窦性心律(SR)患者中,与安慰剂相比,利拉鲁肽使 HR 增加 8 ± 9 bpm(脉搏测量)、9 ± 9 bpm(心电图测量)和 9 ± 6 bpm(设备读数)(均<.005)。HR 增加与利拉鲁肽剂量相关( = .01)。无 SR 的患者 HR 无变化。严重心脏不良事件与 HR 变化无关。在接受 SR 的 CHF 患者中,利拉鲁肽治疗 6 个月期间 HR 显著增加,但与不良事件无关。需要确定利拉鲁肽治疗的 CHF 患者 HR 增加的长期临床意义。

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