杨明明,陈立娟,马根山

• 1:东南大学附属中大医院心内科

摘要(Abstract)：

<正>心力衰竭是世界上危害人类健康的主要心血管疾病之一,其发病率和死亡率迅速上升,每年所消耗的医疗成本巨大[1]。心力衰竭在所有住院患者中约占5%,在随访12个月内再入院率接近50%[2]。由于β阻滞药有降低交感神经兴奋性,降低心率并改善心脏充盈等重要作用,目前与血管紧张素转换酶抑制药(angiotensin converting enzyme inhibitor,ACEI)和醛固酮拮抗药联合用于心力衰竭患者的治疗,以期降低这类患者的死亡率[3]。目前美国以及欧洲心力衰竭治疗指南,均将β阻滞药列为用于治疗有症状的收缩期心力衰竭患者的Ⅰ类推荐[4-5]。然而,目前临床

关键词(KeyWords)： β阻滞药;射血分数降低;心力衰竭;肾功能不全

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 杨明明,陈立娟,马根山

参考文献(References)：

• [1] Lloyd-Jones D, Adams RJ, Brown TM, et al. Heart disease and stroke statistics--2010 update:a report from the American Heart Association. Circulation,2010,121(7):e46-e215.
• [2] Kotecha D, Manzano L, Altman DG, et al. Individual patient data meta-analysis of beta-blockers in heart failure:rationale and design.Syst Rev,2013,2:7.
• [3] Al-Gobari M, Al-Aqeel S, Gueyffier F, et al.Effectiveness of drug interventions to prevent sudden cardiac death in patients with heart failure and reduced ejection fraction:an overview of systematic reviews. BMJ Open,2018,8(7):e021108.
• [4] Dickstein K, Cohen-Solal A, Filippatos G, et al. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2008:the Task Force for the diagnosis and treatment of acute and chronic heart failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC(HFA)and endorsed by the European Society of Intensive Care Medicine(ESICM).Eur J Heart Fail,2008,10(10):933-989.
• [5] Jessup M, Abraham WT, Casey DE, et al. 2009 focused update:ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults:a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines:developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation. 2009,119(14):1977-2016.
• [6] Cohen-Solal A, Kotecha D, van Veldhuisen DJ, et al. Efficacy and safety of nebivolol in elderly heart failure patients with impaired renal function:insights from the SENIORS trial. Eur J Heart Fail,2009,11(9):872-880.
• [7] Ghali JK, Wikstrand J, Van Veldhuisen DJ, et al. The influence of renal function on clinical outcome and response to beta-blockade in systolic heart failure:insights from Metoprolol CR/XL Randomized Intervention Trial in Chronic HF(MERIT-HF).J Card Fail,2009,15(4):310-318.
• [8] Ponikowski P, Voors AA, Anker SD, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure:The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology(ESC). Developed with the special contribution of the Heart Failure Association(HFA)of the ESC. Eur J Heart Fail,2016,18(8):891-975.
• [9] Kotecha D. Beta-blockers reduce death in patients with heart failure and moderate renal impairment. https://www.escardio.org/The-ESC/Press-Office/Press-releases/beta-blockers-reduce-death-in-patientswith-heart-failure-and-moderate-renal-impairment.
• [10] Kotecha D, Flather MD, Altman DG, et al. Heart rate and rhythm and the benefit of beta-blockers in patients with heart failure.J Am Coll Cardiol,2017,69(24):2885-2896.
• [11] Kotecha D, Holmes J, Krum H, et al. Efficacy ofβblockers in patients with heart failure plus atrial fibrillation:an individualpatient data meta-analysis. Lancet,2014,384(9961):2235-2243.