Pei Zuowei, Dong Min, Meng Xuyang, Yao Wei, Guo Ying, Wang Fang
Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, 100730 Beijing, China.
Department of Cardiology, Central Hospital of Dalian University of Technology, 116033 Dalian, Liaoning, China.
Rev Cardiovasc Med. 2024 Aug 21;25(8):297. doi: 10.31083/j.rcm2508297. eCollection 2024 Aug.
Heart failure (HF) is the main cause of death in middle-aged and older people and is characterized by high morbidity, high mortality, a high rehospitalization rate, and many high-risk groups. Nicotinamide adenine dinucleotide (NAD) is widely present in the mitochondria of cardiomyocytes and maintains the redox balance in the body, which can effectively treat HF. We sought to evaluate whether NAD therapy has some clinical efficacy in patients with HF.
Based on using conventional drugs to treat HF, patients (n = 60) were randomized 1:1 to saline and 50 mg NAD with 50 mL of normal saline for 7 days. The baseline characteristics of patients before and after treatment and cardiac function (N-terminal pro B-type natriuretic peptide (NT-proBNP) level and left ventricular ejection fraction (LVEF) value) were analyzed. Serological analysis (sirtuin-1 (SIRT1), sirtuin-3 (SIRT3), sirtuin-6 (SIRT6), reactive oxygen species (ROS), and endothelin) was also performed.
Among the 60 patients with HF who were treated with NAD for 7 days, the improvement rate in NT-proBNP levels and LVEF values was better than in the saline group, although not statistically significant. These patients were more likely to benefit from NAD because of higher levels of anti-oxidative stress (SIRT1, SIRT3, SIRT6, and ROS) and anti-endothelial injury (endothelin) than those in the saline control group.
According to the results of this study, it is believed that 7 days of NAD injections has a positive effect on improving cardiac function, oxidative stress, and endothelial injury in patients with HF compared with the saline control.
Chinese Clinical Trial Registry (http://www.chictr.org.cn/) ChiCTR2300074326; retrospectively registered on 3 August 2023.
心力衰竭（HF）是中老年人群主要的死亡原因，具有高发病率、高死亡率、高再住院率以及众多高危人群的特点。烟酰胺腺嘌呤二核苷酸（NAD）广泛存在于心肌细胞线粒体中，维持机体氧化还原平衡，可有效治疗心力衰竭。我们旨在评估NAD治疗对心力衰竭患者是否具有一定临床疗效。
在使用常规药物治疗心力衰竭的基础上，将患者（n = 60）按1:1随机分为生理盐水组和50 mg NAD加50 mL生理盐水组，治疗7天。分析患者治疗前后的基线特征及心功能（N末端B型利钠肽原（NT-proBNP）水平和左心室射血分数（LVEF）值）。还进行了血清学分析（沉默调节蛋白1（SIRT1）、沉默调节蛋白3（SIRT3）、沉默调节蛋白6（SIRT6）、活性氧（ROS）和内皮素）。
在60例接受NAD治疗7天的心力衰竭患者中，NT-proBNP水平和LVEF值的改善率虽无统计学意义，但优于生理盐水组。与生理盐水对照组相比，这些患者因抗氧化应激（SIRT1、SIRT3、SIRT6和ROS）和抗内皮损伤（内皮素）水平较高，更可能从NAD治疗中获益。
根据本研究结果，认为与生理盐水对照相比，7天的NAD注射对改善心力衰竭患者的心功能、氧化应激和内皮损伤具有积极作用。
中国临床试验注册中心（http://www.chictr.org.cn/）ChiCTR2300074326；于2023年8月3日追溯注册。
