Left ventricular remodelling in systolic heart failure using ivabradine. Slower is smaller is better?
Left ventricular remodelling in systolic heart failure using ivabradine. Slower is smaller is better?
复制标题
使用伊伐布雷定治疗收缩性心力衰竭的左心室重构。
作者：
F. Fruhwald;B. Pieske
这篇社论参考了J.C.的“伊伐布雷定选择性降低心率对左心室重塑和功能的影响：来自心脏超声子研究的结果”。Tardif等人，doi：10.1093/eurheartj/ehr 311
Tardif及其同事发表了该试验的超声心动图子研究。1该预定义子研究纳入了6505例来自于ESTA的患者中的611例，换句话说，占在SHIFT中研究的整个队列的9.3%。2作者报告称，在这611例患者中，必须排除96例伊伐布雷定治疗患者和104例安慰剂治疗患者，主要是由于不完整或不可读的超声心动图记录，伊伐布雷定组有208例患者，安慰剂组有203例患者用于分析。对超声心动图进行集中分析，并在基线和8个月后进行调查，主要终点为8个月时左心室收缩期容积指数（LVESVI）的变化。这个治疗良好的人群[92%接受β受体阻滞剂治疗，56%服用推荐剂量的50%，94%接受肾素-血管紧张素系统（RAS）拮抗剂治疗]与整个队列没有什么不同，除了高血压和高血压的发生率较低。
This editorial refers to ‘Effects of selective heart rate reduction with ivabradine on left ventricular remodelling and function: results from the SHIFT echocardiographic substudy’ by J.C. Tardif et al. , doi:10.1093/eurheartj/ehr311
Tardif and co-workers have published the echocardiographic substudy of the SHIFT trial.1 This pre-defined substudy included 611 out of 6505 patients from SHIFT, or, in other words, 9.3% of the entire cohort studied in SHIFT.2 The authors report that of these 611 patients, 96 ivabradine- and 104 placebo-treated patients had to be excluded, mainly due to incomplete or unreadable echo recordings, which left 208 patients in the ivabradine group and 203 in the placebo group for analysis. The echoes were analysed centrally and the investigations were done at baseline and after 8 months, with the primary endpoint of change of left ventricular systolic volume index (LVESVI) at 8 months. This well-treated population [92% were on beta-blockers, with 56% taking 50% of the recommended dose, and 94% were treated with a renin–angiotensin system (RAS) antagonist] was not different from the entire SHIFT cohort, except for a lower rate of hypertension and a …