达格列净对高度房室传导阻滞起搏器植入术后患者心功能及心房高频事件的影响

Effects of dapagliflozin on cardiac function and atrial high rate episode in patients with high-grade atrioventricular block after pacemaker implantation

目的探讨达格列净对高度房室传导阻滞起搏器植入术后患者心功能及心房高频事件(AHRE)的影响。方法选取我院心内科2022年6月至2023年6月收治的80例高度房室传导阻滞起搏器植入术后患者为研究对象,采取随机数字表法将其分为对照组与研究组,每组40例。对照组在常规抗心衰治疗基础上使用沙库巴曲缬沙坦,研究组在对照组的基础上增加达格列净治疗。比较两组的治疗效果。结果治疗前、后,研究组的美国纽约心脏病协会(NYHA)分级比较,差异具有统计学意义(P<0.05);治疗前、后,对照组的NYHA分级比较,差异具有统计学意义(P<0.05)。治疗后,两组的左室射血分数(LVEF)、短轴缩短率(FS)显著高于治疗前,且研究组高于对照组(P<0.05)。治疗后,两组的6 min步行试验距离大于治疗前,脑钠肽(BNP)水平低于治疗前,且研究组优于对照组(P<0.05)。出院时及随访6个月,研究组的心房颤动发生频率低于对照组,心房颤动持续时间短于对照组(P<0.05);随访6个月,研究组的心房颤动发生频率低于出院时,心房颤动持续时间短于出院时(P<0.05)。结论达格列净能够有效提升高度房室传导阻滞起搏器植入术后患者的心功能,同时还能够有效降低AHRE的发生风险。

Objective To explore the effect of dapagliflozin on cardiac function and atrial high rate episode(AHRE)in patients with high-grade atrioventricular block after pacemaker implantation.Methods A total of 80 patients with high-grade atrioventricular block after pacemaker implantation admitted in the cardiology department of our hospital from June 2022 to June 2023 were selected as the research objects.The patients were divided into control group and study group by random number table method,with 40 cases in each group.The control group was treated with sacubitril valsartan on the basis of conventional anti heart failure treatment,and the study group was treated with dapagliflozin on the basis of the control group.The therapeutic effects of the two groups were compared.Results Before and after treatment,there was statistically significant difference in New York Heart Association(NYHA)classification of the study group(P<0.05);before and after treatment,there was statistically significant difference in NYHA classification of the control group(P<0.05).After treatment,the left ventricular ejection fraction(LVEF)and fractional shortening(FS)in the two groups were significantly higher than those before treatment,and those in the study group were higher than the control group(P<0.05).After treatment,the 6 min walking test distance of the two groups was longer than that before treatment,the brain natriuretic peptide(BNP)level was lower than that before treatment,and those in the study group were better than the control group(P<0.05).At discharge and 6 months of follow-up,the frequency of atrial fibrillation in the study group was lower than that in the control group,and the duration of atrial fibrillation was shorter than that in the control group(P<0.05);at 6 months of follow-up,the frequency of atrial fibrillation in the study group was lower than that at discharge,and the duration of atrial fibrillation was shorter than that at discharge(P<0.05).Conclusion Dapagliflozin can effectively improve the cardiac function of patients with high-grade atrioventricular block after pacemaker implantation,and also effectively reduce the risk of AHRE.