Changes in NT-proBNP levels in patients with sinus tachycardia after COVID-19
Changes in NT-proBNP levels in patients with sinus tachycardia after COVID-19
复制标题
COVID-19 后窦性心动过速患者 NT-proBNP 水平的变化
DOI：
10.15829/1728-8800-2022-3485
复制
发表时间：
2023
影响因子：
--
通讯作者：
A. Ivannikov
中科院分区：
文献类型：
--
作者：
V. Podzolkov;A. Bragina;A. Tarzimanova;T. Vargina;E. S. Ogibenina;I. Shvedov;E. E. Bykova;A. Ivannikov
瞄准评价伊伐布雷定单药治疗或与β受体阻滞剂（BB）联合治疗期间与BB单药治疗相比，2019冠状病毒病（COVID-19）后窦性心动过速患者N末端脑钠肽前体（NT-proBNP）浓度的变化。材料和方法。这项随机对照研究纳入了90名在COVID-19急性期后出院的患者。主要组（n = 60）包括在标准治疗基础上接受伊伐布雷定单药治疗或联合BB治疗的患者，而对照组（n = 30）-标准治疗联合BB治疗。随访期为24周。在首次和末次访视（0和24周）时，通过酶免疫法测定血清NT-proBNP浓度。使用STATISTICA 8.0软件进行统计处理。P <0.05有统计学意义。在两组中均观察到心率（HR）和NT-proBNP浓度显著降低。试验组和对照组中最大推荐BB剂量的实现率分别为9.1%和20%。在未达到最大推荐剂量BB的个体中，对照组的HR和NT-proBNP浓度显著较高，如下：72 [66; 75] vs 68 [66; 75] bpm（p = 0，028）和55.5 [47.3; 88.8] vs 43.3 [31.0; 55，5] pg/ml（p = 0，041）。我们发现，在COVID-19后患者HR降低的背景下，伊伐布雷定和β受体阻滞剂治疗有助于降低NT-proBNP水平，伊伐布雷定可使未能达到最大推荐BB剂量的患者的心率和NT-proBNP水平更明显降低。
Aim. To evaluate the changes of the N-terminal pro-brain natriuretic peptide (NT-proBNP) concentration in patients with sinus tachycardia after coronavirus disease 2019 (COVID-19) during ivabradine monotherapy or in combination with β-blockers (BBs) compared to BB monotherapy.Material and methods. This randomized comparative study included 90 patients discharged from the hospital after an acute period of COVID-19. The main group (n=60) included patients who received ivabradine monotherapy or in combination with BB in addition to standard therapy, while the control group (n=30) — standard therapy in combination with BB. The follow-up period lasted 24 weeks. Serum NT-proBNP concentration was determined by enzyme immunoassay at the first and last visit (0 and 24 weeks). Statistical processing was performed using STATISTICA 8.0 software. The level of statistical significance was p<0,05.Results. A significant decrease in heart rate (HR) and NT-proBNP concentration was noted in both groups. The achievement rate of maximum recommended BB doses was 9,1% in the main group and 20% in the control group. Among individuals who did not achieve the maximum recommended doses of BB, the HR and NT-proBNP concentration were significantly higher in the control group as follows: 72 [66; 75] vs 68 [66; 75] bpm (p=0,028) and 55,5 [47,3; 88,8] vs 43,3 [31,0; 55,5] pg/ml, respectively (p=0,041).Conclusion. We showed that therapy with ivabradine and betablockers helps to reduce the level of NT-proBNP against the background of HR decrease in patients after COVID-19, and ivabradine allows to achieve a more pronounced decrease in heart rate and NT-proBNP level in patients with failure to achieve the maximum recommended BB doses.