心力衰竭能量代谢治疗

心力衰竭能量代谢治疗内容摘要：

老年冠心病 Rosano et al 2020 Kolbel et al (TIGER) 2020 Vitale et al 2020 缺血性心肌病 Di Napoli et al 2020 ElKady et al 2020 雷诺嗪 ： 抗心绞痛研究 （ ERICA Study） Ranolazine extendedrelease 500 mg bid (1 week) then 1000 mg bid n = 281 Placebo n = 284 History of CAD* Stable angina (≥3 angina episodes/week) Amlodipine 10 mg/day N = 565 7 weeks Primary efficacy variable: Angina frequency (weekly average) Randomized Doubleblind Evaluation of Ranolazine In Chronic Angina *≥60% stenosis, previous MI, and/or stressinduced perfusion defect Stone PH et al. J Am Coll Cardiol. 2020。 48:56675. 雷诺嗪： 减少心绞痛和硝酸酯类用量 Placebo Ranolazine 1000 mg bid Nitroglycerin use Angina episodes P = P = 0 1 2 3 4 5 6 Baseline Week 7 Baseline Week 7 Mean number per week Stone PH et al. J Am Coll Cardiol. 2020。 48:56675. UA/NSTEMI (ModerateHigh Risk) Ranolazine IV to PO Placebo Matched IV/PO RANDOMIZE (1:1) Doubleblind Holter Longterm Followup (Median 348 Days) Standard Therapy N = 6560 Morrow DA et al. JAMA 2020。 297: 177583 雷诺嗪 ： 改善 UA/NSTEMI患者预后的研究 Fragakis N et al. Am J Cardiol. 2020 May 21. [Epub ahead of print 雷诺嗪：抗房颤作用 与胺碘酮联用，增加房颤转复成功率 L卡尼汀是脂肪酸代谢的必需辅助因子，它能将心肌细胞胞浆中堆积的FFA转入线粒体，促进心肌由 CHF时的无氧糖酵解重新回到脂肪酸氧化，使心肌能量代谢恢复正常。 心肌代谢疗法 —底物的调节 促进脂肪酸氧化 ： L卡尼丁 肉毒碱缺乏 脂肪酸 β 氧化障碍 游离脂肪酸增多 能量产生障碍 脂肪酸代谢产物堆积 Effect of Lcarnitine on glucose oxidation rates in control and diabetic rat heart hearts before and after ischaemia. Values are the means of 7 untreated control, 8 Lcarnitine treated control, 8 untreated diabetic and 8 Lcarnitine treated diabetic rat hearts. Glucose oxidation rates were determi。