心力衰竭患者出现 Bendopnea 对实现治疗目标剂量的影响。
Effect of Bendopnea on Achievement Medical Treatment Target Doses in Heart Failure.
机构信息
Department of Cardiology, Antalya Training and Research Hospital, University of Health Sciences, Antalya, Turkey.
Department of Cardiology, Sivas Cumhuriyet University, Sivas, Turkey.
出版信息
Arch Iran Med. 2023 Jan 1;26(1):36-42. doi: 10.34172/aim.2023.06.
BACKGROUND
The newly described bendopnea in heart failure (HF) is associated with increased cardiac filling pressures. The aim of the study was to show the effect of bendopnea follow-up on reaching optimal medical treatment doses in HF.
METHODS
A total of 413 patients were screened, and we included 203 patients with HF who were previously evaluated for bendopnea. Demographic data, presence or absence of bendopnea, medical history, laboratory findings, and medical treatments were evaluated. Optimal medical therapy target doses at baseline and 3rd month were compared in groups with and without bendopnea.
RESULTS
On admission, 64 patients (31.5%) had bendopnea. The rate of patients with bendopnea decreased in the 3rd month (n=42, 20.7%). The proportion of patients who used at least 50% of the recommended medical treatment dose on admission and in the 3rd month was compared; angiotensin-converting enzyme inhibitor /angiotensin receptor blockers use increased from 40.6% to 71.9% in those with bendopnea (=0.013), from 56.1% to 81.3% in those without bendopnea (<0.001) and beta-blockers use increased from 28.2% to 60.9% in those with bendopnea (=0.042), from 31.6% to 69.8% in those without bendopnea (<0.001). However, aldosterone antagonists use decreased from 70.3% to 67.2% in those with bendopnea (=0.961), from 68.4 % to 64.1% in those without bendopnea (=0.334). Bendopnea was independently effective in achieving ACE-I/ARB target doses (OR: 0.359, CI 95%: 0.151-0.854, =0.020).
CONCLUSION
Bendopnea follow-up in HF patients can provide a significant improvement in reaching the recommended treatment target doses.
背景
新描述的心力衰竭（HF）中的弯腰呼吸困难与增加的心脏充盈压有关。本研究的目的是显示弯腰呼吸困难随访对达到 HF 最佳药物治疗剂量的影响。
方法
共筛选了 413 名患者，我们纳入了 203 名先前评估过弯腰呼吸困难的 HF 患者。评估了人口统计学数据、弯腰呼吸困难的存在或不存在、病史、实验室发现和药物治疗。比较了有和没有弯腰呼吸困难的患者在基线和第 3 个月的最佳药物治疗目标剂量。
结果
入院时，64 名患者（31.5%）有弯腰呼吸困难。第 3 个月弯腰呼吸困难的患者比例下降（n=42，20.7%）。比较了入院和第 3 个月至少使用推荐药物治疗剂量 50%的患者比例；在有弯腰呼吸困难的患者中，血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂的使用率从 40.6%增加到 71.9%（=0.013），在没有弯腰呼吸困难的患者中从 56.1%增加到 81.3%（<0.001），β-受体阻滞剂的使用率从 28.2%增加到 60.9%（=0.042），在有弯腰呼吸困难的患者中从 31.6%增加到 69.8%（<0.001）。然而，在有弯腰呼吸困难的患者中，醛固酮拮抗剂的使用率从 70.3%降至 67.2%（=0.961），在没有弯腰呼吸困难的患者中从 68.4%降至 64.1%（=0.334）。弯腰呼吸困难对达到 ACE-I/ARB 目标剂量独立有效（OR：0.359，95%CI：0.151-0.854，=0.020）。
结论
HF 患者的弯腰呼吸困难随访可以显著提高达到推荐治疗目标剂量的效果。
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