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高剂量他汀类药物预处理是否会影响接受瓣膜置换术患者的整体应变?

Does high dose statin pretreatment affect global strains in patients undergoing valve replacement.

作者信息

Prajapathi Sudesh, Kapoor Aditya, Agarwal Surendra Kumar, Tewari Prabhat, Pande Shantanu, Chandra Bipin, Sahu Ankit, Khanna Roopali, Kumar Sudeep, Garg Naveen, Tewari Satyendra

机构信息

Department of Cardiology, Sanjay Gandhi PGIMS, Lucknow, 226014 India.

Cardiovascular and Thoracic Surgery, Sanjay Gandhi PGIMS, Lucknow, 226014 India.

出版信息

Indian J Thorac Cardiovasc Surg. 2024 May;40(3):300-310. doi: 10.1007/s12055-023-01652-y. Epub 2023 Dec 22.

Abstract

PURPOSE

To study the effect of rosuvastatin 40 mg (initiated 7 days prior to surgery) in patients undergoing valve replacement (VR) for rheumatic mitral valve disease on left ventricular (LV) strain and biomarker release kinetics.

METHODS

In this randomized study, cardiac biomarkers viz. troponin I (TnI), Creatine kinase MB (CK-MB), N-terminal pro B-type natriuretic peptide (NTPBNP) were measured before surgery; and 8, 24 and 48 h postoperatively. Global LV (circumferential, global circumferential strain (GCS); longitudinal, GLS; radial, global radial strain (GRS)) strains were measured preoperatively; and 48 h and 30 days postoperatively.

RESULTS

Following VR, Global Longitudinal Strain (GLS), Global Circumferential Strain (GCS) and Global Radial Strain (GRS) declined at 48 h in both statin loaded (SL) and non loaded (NL) groups. The (% change in GLS 35.8% vs 38.8%, GCS 34% vs 44.1%, GRS 45.7% vs 52.6%; p < 0.001). (GLS -15.92 ± 2.00% vs -12.6 ± 1.66%, GCS -15.12 ± 2.93% vs -13.04 ± 2.44%; GRS 22.12 ± 6.85% vs 19.32 ± 6.48%). at 8, 24 and 48 h were Mean change (baseline to peak biomarker value) was also significantly lower in SL group.The SL group had . On postoperative 30 day .

CONCLUSION

Pre-operative high dose rosuvastatin was "cardioprotective" with favorable effect on LV global strain and release kinetics of biomarkers. These cut-offs (described for the first time for rheumatic VR) can be used as prognostic predictors.

摘要

目的

研究在接受风湿性二尖瓣疾病瓣膜置换术(VR)的患者中,术前7天开始使用40毫克瑞舒伐他汀对左心室(LV)应变和生物标志物释放动力学的影响。

方法

在这项随机研究中,在手术前以及术后8、24和48小时测量心脏生物标志物,即肌钙蛋白I(TnI)、肌酸激酶同工酶MB(CK-MB)、N末端B型利钠肽原(NTPBNP)。术前以及术后48小时和30天测量左心室整体应变(圆周方向,整体圆周应变(GCS);纵向,整体纵向应变(GLS);径向,整体径向应变(GRS))。

结果

瓣膜置换术后,他汀类药物负荷组(SL)和非负荷组(NL)在术后48小时时整体纵向应变(GLS)、整体圆周应变(GCS)和整体径向应变(GRS)均下降。(GLS变化百分比为35.8%对38.8%,GCS为34%对44.1%,GRS为45.7%对52.6%;p<0.001)。(GLS -15.92±2.00%对-12.6±1.66%,GCS -15.12±2.93%对-13.04±2.44%;GRS 22.12±6.85%对19.32±6.48%)。SL组在8、24和48小时时生物标志物的平均变化(从基线到峰值生物标志物值)也显著更低。SL组有……。术后30天……。

结论

术前高剂量瑞舒伐他汀具有“心脏保护作用”,对左心室整体应变和生物标志物释放动力学有有利影响。这些临界值(首次针对风湿性VR描述)可作为预后预测指标。

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