中国临床医学2025，Vol.32Issue(3)：342-349,8.DOI:10.12025/j.issn.1008-6358.2025.20250497
达格列净在阵发性心房颤动合并射血分数保留型心力衰竭中的作用:一项随机对照研究
Effect of dapagliflozin in paroxysmal atrial fibrillation combined with heart failure with preserved ejection fraction:a randomized controlled trial
摘要
Abstract
Objective To explore the efficacy and safety of dapagliflozin in patients with paroxysmal atrial fibrillation(PAF)combined with heart failure with preserved ejection fraction(HFpEF).Methods A total of 120 patients with PAF combined with HFpEF treated at Jinshan Hospital of Fudan University from July 2022 to July 2023 were selected and randomly divided into the dapagliflozin group(n=60,standard treatment combined with dapagliflozin)and the control group(n=60,standard treatment combined with placebo).After 12 months of follow-up,the Kansas City Cardiomyopathy Questionnaire-Total Symptom Score(KCCQ-TSS),PAF duration,recurrence rate and frequency of PAF,left atrial diameter,left ventricular end-systolic diameter,left ventricular end-diastolic diameter,left ventricular ejection fraction,P-wave dispersion,blood pressure,plasma N-terminal pro-brain natriuretic peptide(NT-proBNP),estimated glomerular filtration rate(eGFR),and glycated hemoglobin A1C(HbA1C)were compared between the two groups.Cardiovascular outcomes and adverse events were observed.Results A total of 10 patients lost to follow-up,and 110 patients were included in the analysis(55 in each group).After 12 months of treatment,the KCCQ-TSS in the dapagliflozin group was significantly higher than that in the control group([61.68±2.65]points vs[44.98±4.76]points,P＜0.001).The PAF duration in the dapagliflozin group was significantly shorter than that in the control group([144±18]min vs[270±24]min,P=0.045).After treatment,frequency of PAF,NT-proBNP levels,left ventricular end-systolic diameter,left ventricular end-diastolic diameter,left atrial diameter,P-wave dispersion,and HbA1C levels showed statistical differences between the two groups(P＜0.05).The heart failure readmission rate and PAF recurrence rate in the dapagliflozin group were significantly lower than those in the control group(P＜0.05).There was no significant difference in the incidence of adverse events between the two groups during treatment.Conclusions Dapagliflozin improves patients'quality of life,reduces PAF duration and recurrence rate,decreases heart failure readmission rate,lowers NT-proBNP levels,reverses cardiac remodeling,and demonstrates favorable safety in patients with PAF combined with HFpEF.关键词
达格列净/射血分数保留型心力衰竭/阵发性心房颤动/堪萨斯城心肌病问卷总症状评分Key words
dapagliflozin/heart failure with preserved ejection fraction/paroxysmal atrial fibrillation/Kansas City Cardiomyopathy Questionnaire-Total Symptom Score分类
医药卫生引用本文复制引用
连晓雨,彭飞,龚辉,钱菊英..达格列净在阵发性心房颤动合并射血分数保留型心力衰竭中的作用:一项随机对照研究[J].中国临床医学,2025,32(3):342-349,8.基金项目
上海市卫生健康委员会科研项目(20214Y0367),复旦大学附属金山医院青年科研启动基金(JYQN-LC-202204).Supported by Scientific Research Project of Shanghai Municipal Health Commission(20214Y0367)and Youth Scientific Research Startup Fund(Clinical Project)of Jinshan Hospital of Fudan University(JYQN-LC-202204). （20214Y0367）
