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达格列净对心肌梗死后早期心力衰竭患者心率变异性、心功能及短期预后的影响

Effects of dapagliflozin on heart rate variability, cardiac function, and short-term prognosis in early-onset post-myocardial infarction heart failure.

作者信息

Zhou Le, Niu Mingyuan, Chen Wei, Hu Qian, Chen Yi, Geng Xiaohong, Gu Jiani

机构信息

Department of Cardiology, Shibei Hospital of Jing'an District, Shanghai, China.

Department of Cardiology, Shigatse People's Hospital, Xizang, China.

出版信息

Front Cardiovasc Med. 2025 Jan 6;11:1490316. doi: 10.3389/fcvm.2024.1490316. eCollection 2024.

Abstract

OBJECTIVE

To investigate the effects of dapagliflozin, in addition to standard therapy, on heart rate variability (HRV), soluble growth stimulation expressed gene 2 protein (sST2), N-terminal pro B-type natriuretic peptide (NT-proBNP), and echocardiographic parameters in patients with early-onset post-myocardial infarction heart failure (HF).

METHODS

A total of 98 patients with early-onset post-myocardial infarction HF were enrolled and randomly divided into a control group ( = 48, receiving standard therapy) and an observation group ( = 50, receiving standard therapy plus dapagliflozin 10 mg daily). HRV, cardiac function, and echocardiographic parameters were measured at baseline and after 24 weeks of treatment. Short-term prognosis and adverse events were also monitored.

RESULTS

Compared with the control group, the observation group showed significantly greater improvements in SDNN and SDANN ( < 0.05). Significant improvements were also observed in sST2 and NT-proBNP levels in the observation group compared to the control group ( < 0.05). Additionally, echocardiographic parameters, including EF, LVESD, LVEDD, IVST, LVMI, and E/e', showed greater improvement in the observation group ( < 0.05). The incidence of major adverse cardiovascular events was lower in the observation group ( < 0.05). Multivariate logistic regression model revealed that dapagliflozin use was independently associated with a reduced risk of MACE (OR = 0.265, 95% CI: 0.097-0.724,  = 0.010).

CONCLUSION

Early administration of dapagliflozin 10 mg, in addition to standard therapy, can improve autonomic function, cardiac function, and short-term prognosis in patients with early-onset post-myocardial infarction heart failure.

摘要

目的

探讨在标准治疗基础上加用达格列净对心肌梗死后早期心力衰竭(HF)患者心率变异性(HRV)、可溶性生长刺激表达基因2蛋白(sST2)、N末端B型利钠肽原(NT-proBNP)及超声心动图参数的影响。

方法

共纳入98例心肌梗死后早期HF患者,随机分为对照组(n = 48,接受标准治疗)和观察组(n = 50,接受标准治疗加每日10 mg达格列净)。在基线和治疗24周后测量HRV、心功能和超声心动图参数。同时监测短期预后和不良事件。

结果

与对照组相比,观察组的SDNN和SDANN改善更为显著(P < 0.05)。与对照组相比,观察组的sST2和NT-proBNP水平也有显著改善(P < 0.05)。此外,包括EF、LVESD、LVEDD、IVST、LVMI和E/e'在内的超声心动图参数在观察组改善更为明显(P < 0.05)。观察组主要不良心血管事件的发生率较低(P < 0.05)。多因素逻辑回归模型显示,使用达格列净与降低主要不良心血管事件风险独立相关(OR = 0.265,95%CI:0.097 - 0.724,P = 0.010)。

结论

在标准治疗基础上早期给予10 mg达格列净可改善心肌梗死后早期心力衰竭患者的自主神经功能、心功能和短期预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf5d/11743520/adfd1bef908a/fcvm-11-1490316-g001.jpg

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