Theophylline and Cardiac Stress in Patients with Dyspnea: An Observational Study
Theophylline and Cardiac Stress in Patients with Dyspnea: An Observational Study
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茶碱与呼吸困难患者的心脏应激：一项观察性研究
DOI：
10.1159/000318853
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发表时间：
2010
期刊：
影响因子：
3.1
通讯作者：
B. Basler
中科院分区：
文献类型：
--
作者：
S. Wieshammer;J. Dreyhaupt;B. Basler
背景/目标：茶碱在低血清浓度下的抗炎作用的认识已经恢复了对这种药物的兴趣，但其心脏副作用仍然是一个问题。血清N末端脑钠肽原（NT-proBNP）水平是心脏应激的标志物。本研究检查了茶碱摄入量与NT-proBNP之间的相关性。研究方法：通过多元回归分析，在753例转诊进行呼吸困难肺部评估的门诊患者中前瞻性评估了茶碱对NT-proBNP的影响。结果如下：在548名哮喘、慢性阻塞性肺疾病或呼吸肌无力患者中，107名正在服用茶碱（中位血清浓度为8.1 µg/ml）。与未服用茶碱的患者相比，服用茶碱的患者年龄更大（平均64.5 ± 11.6岁对56.5 ± 16.8岁，p <0.01），气道阻塞更严重（p < 0.01），心脏病患病率更高（33.6%对23.1%，p = 0.02）。在心脏病患者（n = 138）中，茶碱治疗患者（n = 36）的NT-proBNP校正水平低于（p < 0.01）未使用茶碱的患者（中位数144.5 vs. 236.4 pg/ml）。茶碱对无心脏病患者的NT-proBNP无影响。结论：这项观察性研究的结果对传统观点提出了质疑，即即使是低剂量的茶碱治疗也可能对共存心脏病的患者有害。
Background/Aims: Appreciation of the anti-inflammatory actions of theophylline at low serum concentrations has revived the interest in this drug, but its cardiac side effects remain a concern. The serum level of N-terminal probrain natriuretic peptide (NT-proBNP) is a marker for cardiac stress. This study examined the association between theophylline intake and NT-proBNP. Methods: The effect of theophylline on NT-proBNP was prospectively evaluated by multiple regression analysis in 753 outpatients referred for pulmonary evaluation of dyspnea. Results: Of 548 patients with asthma, chronic obstructive pulmonary disease or respiratory muscle weakness, 107 were taking theophylline (median serum concentration 8.1 µg/ml). The theophylline users were older (mean 64.5 ± 11.6 vs. 56.5 ± 16.8 years, p < 0.01), had severer airway obstruction (p < 0.01) and had a higher prevalence of heart disease (33.6 vs. 23.1%, p = 0.02) than the patients not taking theophylline. Among the patients with heart disease (n = 138), the adjusted levels of NT-proBNP were lower (p < 0.01) in the theophylline-treated patients (n = 36) than in the patients not using theophylline (median 144.5 vs. 236.4 pg/ml). Theophylline had no effect on NT-proBNP in patients without heart disease. Conclusion: The results of this observational study call into question the traditional view that even low-dose theophylline therapy may be detrimental in patients with coexisting heart disease.
影响因子：
158.5
作者：
Wang, TJ;Larson, MG;Vasan, RS
通讯作者：
Vasan, RS
影响因子：
9.3
作者：
Levey, Andrew S.;Coresh, Josef;Van Lente, Frederick
通讯作者：
Van Lente, Frederick
影响因子：
2.8
作者：
Wang, TJ;Larson, MG;Vasan, RS
通讯作者：
Vasan, RS