Prognostic Impact of Landiolol in Patients with Acute Heart Failure and Atrial Fibrillation with Rapid Ventricular Rates: A Pilot Observational Study.
Prognostic Impact of Landiolol in Patients with Acute Heart Failure and Atrial Fibrillation with Rapid Ventricular Rates: A Pilot Observational Study.
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兰地洛尔对急性心力衰竭和心室快速心房颤动患者的预后影响：一项试点观察研究。
DOI：
10.1159/000525852
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Nobuhisa Hagiwara.
中科院分区：
文献类型：
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作者：
Shota Shirotani;Kentaro Jujo;Takuro Abe;Motoko Kametani;Yuichiro Minami;Atsushi Suzuki;Tsuyoshi Shiga;Nobuhisa Hagiwara.
指南建议急性失代偿性心力衰竭（ADHF）患者在房颤（AF）期间将心室率控制在< 130 bpm，以避免心输出量恶化。我们旨在评估兰地洛尔对ADHF和AF患者预后的影响。MethodsThis观察性研究包括60例ADHF患者，入院时出现AF和心率（HR）≥ 130 bpm。根据患者入院后24 h内静脉注射兰地洛尔的使用情况，将患者分为兰地洛尔组（n= 37）和对照组（n= 23）。主要终点是任何原因导致的死亡。兰地洛尔组在入院后2 h心率显著降低。入院后48 h，兰地洛尔组HR显著低于对照组（111.6 vs. 97.9 bpm，p= 0.02），HR绝对降幅更大（− 32.2 vs. − 50.0 bpm，p= 0.006）。兰地洛尔组的死亡率明显低于参考组（对数秩检验，p= 0.032）。入院后24小时内使用兰地洛尔与较低的全因死亡率独立相关（校正风险比：0.15，95%可信区间：0.02-0.92）.结论急性期接受兰地洛尔控制心率的ADHF和AF患者比未接受兰地洛尔的患者有更好的预后。
IntroductionGuidelines recommend ventricular rate control to< 130 bpm during atrial fibrillation (AF) in patients with acute decompensated heart failure (ADHF) to avoid aggravating deteriorations in cardiac outputs. We aimed to evaluate the prognostic impact of landiolol in patients with ADHF and AF.MethodsThis observational study included 60 patients who were urgently hospitalized with ADHF and presented with AF and a heart rate (HR)≥ 130 bpm at admission. The patients were assigned to the landiolol group (n= 37) or the reference group (n= 23) based on their intravenous landiolol use within 24 h after admission. The primary endpoint was death from any cause.ResultsThe groups’ baseline characteristics were similar. A significant HR reduction occurred in the landiolol group at 2 h after admission. Compared with the reference group, the HR was significantly lower (111.6 vs. 97.9 bpm, p= 0.02) and the absolute HR reduction was greater (− 32.2 vs.− 50.0 bpm, p= 0.006) in the landiolol group at 48 h after admission. The landiolol group’s mortality rate was significantly lower than that in the reference group (log-rank test, p= 0.032). landiolol use within 24 h after admission was independently associated with lower all-cause mortality (adjusted hazard ratio: 0.15, 95% confidence interval: 0.02–0.92).ConclusionPatients with ADHF and AF who received landiolol for rate control during the acute phase had better prognoses than those who did not receive landiolol.