請用此 Handle URI 來引用此文件:
http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/52443
完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 林亮宇(Lian-Yu Lin) | |
dc.contributor.author | Jen-Fang Cheng | en |
dc.contributor.author | 鄭人方 | zh_TW |
dc.date.accessioned | 2021-06-15T16:14:57Z | - |
dc.date.available | 2020-08-27 | |
dc.date.copyright | 2020-08-27 | |
dc.date.issued | 2020 | |
dc.date.submitted | 2020-08-07 | |
dc.identifier.citation | Andersen MJ, Borlaug BA. Invasive hemodynamic characterization of heart failure with preserved ejection fraction. Heart Fail Clin 2014;10:435-44. Bonderman D, Pretsch I, Steringer-Mascherbauer R, et al. Acute hemodynamic effects of riociguat in patients with pulmonary hypertension associated with diastolic heart failure (DILATE-1): a randomized, double-blind, placebo-controlled, single-dose study. Chest 2014;146:1274-1285. Borlaug BA, Lewis GD, McNulty SE, et al. Effects of sildenafil on ventricular and vascular function in heart failure with preserved ejection fraction. Circ Heart Fail 2015;8:533-41. Borlaug BA, Koepp KE, Melenovsky V. Sodium Nitrite Improves Exercise Hemodynamics and Ventricular Performance in Heart Failure With Preserved Ejection Fraction. J Am Coll Cardiol 2015;66:1672-82. Fincke R, Hochman JS, Lowe AM, et al. Cardiac power is the strongest hemodynamic correlate of mortality in cardiogenic shock: a report from the SHOCK trial registry. J Am Coll Cardiol 2004;44:340-8. Grossman NL, Fiack CA, Weinberg JM, et al. Pulmonary hypertension associated with heart failure with preserved ejection fraction: acute hemodynamic effects of inhaled iloprost. Pulm Circ 2015;5:198-203. Humbert M, Sitbon O, Simonneau G. Treatment of pulmonary arterial hypertension. N Engl J Med 2004;351:1425-36. Hoendermis ES, Liu LC, Hummel YM, et al. Effects of sildenafil on invasive haemodynamics and exercise capacity in heart failure patients with preserved ejection fraction and pulmonary hypertension: a randomized controlled trial. Eur Heart J 2015;36:2565-73. Kitzman DW, Higginbotham MB, Cobb FR, et al. Exercise intolerance in patients with heart failure and preserved left ventricular systolic function: failure of the Frank-Starling mechanism. J Am Coll Cardiol 1991;17:1065-72. Kisch-Wedel H, Kemming G, Meisner F, et al. Effect of prostaglandin I2 analogues on left ventricular diastolic function in vivo. Eur J Pharmacol 2005;517:208-16. Kraigher-Krainer E, Shah AM, Gupta DK et al. Impaired systolic function by strain imaging in heart failure with preserved ejection fraction. J Am Coll Cardiol. 2014;63(5):447-56. Koller B, Steringer-Mascherbauer R, Ebner CH, et al. Pilot Study of Endothelin Receptor Blockade in Heart Failure with Diastolic Dysfunction and Pulmonary Hypertension (BADDHY-Trial). Heart Lung Circ 2017;26:433-441. Lewis GD, Bossone E, Naeije R, et al. Pulmonary vascular hemodynamic response to exercise in cardiopulmonary diseases. Circulation 2013;128:1470-9. Lang IM, Gaine SP. Recent advances in targeting the prostacyclin pathway in pulmonary arterial hypertension. Eur Respir Rev 2015;24:630-41. Lech AK, Dobrowolski PP, Klisiewicz A, Hoffman P. Exercise-induced changes in left ventricular global longitudinal strain in asymptomatic severe aortic stenosis. Kardiol Pol. 2017;75(2):143-9. Massie BM, Carson PE, McMurray JJ, et al. Irbesartan in patients with heart failure and preserved ejection fraction. N Engl J Med 2008;359:2456-67. Maeder MT, Thompson BR, Brunner-La Rocca HP, et al. Hemodynamic basis of exercise limitation in patients with heart failure and normal ejection fraction. J Am Coll Cardiol 2010;56:855-63. Mubarak KK. A review of prostaglandin analogs in the management of patients with pulmonary arterial hypertension. Respir Med 2010;104:9-21. Olschewski H, Walmrath D, Schermuly R, et al. Aerosolized prostacyclin and iloprost in severe pulmonary hypertension. Ann Intern Med 1996;124:820-4. Olschewski H, Rohde B, Behr J, et al. Pharmacodynamics and pharmacokinetics of inhaled iloprost, aerosolized by three different devices, in severe pulmonary hypertension. Chest 2003;124:1294-304. Olschewski H. Inhaled iloprost for the treatment of pulmonary hypertension. Eur Respir Rev 2009;18:29-34. Obokata M, Olson TP, Reddy YNV, et al. Haemodynamics, dyspnoea, and pulmonary reserve in heart failure with preserved ejection fraction. Eur Heart J 2018;39:2810-2821. Paulus WJ, Tschope C, Sanderson JE, et al. How to diagnose diastolic heart failure: a consensus statement on the diagnosis of heart failure with normal left ventricular ejection fraction by the Heart Failure and Echocardiography Associations of the European Society of Cardiology. Eur Heart J 2007;28:2539-50. Pieske B, Maggioni AP, Lam CSP, et al. Vericiguat in patients with worsening chronic heart failure and preserved ejection fraction: results of the SOluble guanylate Cyclase stimulatoR in heArT failurE patientS with PRESERVED EF (SOCRATES-PRESERVED) study. Eur Heart J 2017;38:1119-1127. Redfield MM, Chen HH, Borlaug BA, et al. Effect of phosphodiesterase-5 inhibition on exercise capacity and clinical status in heart failure with preserved ejection fraction: a randomized clinical trial. JAMA 2013;309:1268-77. Reddy YNV, Olson TP, Obokata M, et al. Hemodynamic Correlates and Diagnostic Role of Cardiopulmonary Exercise Testing in Heart Failure With Preserved Ejection Fraction. JACC Heart Fail 2018;6:665-675. Sablotzki A, Czeslick E, Schubert S, et al. Iloprost improves hemodynamics in patients with severe chronic cardiac failure and secondary pulmonary hypertension. Can J Anaesth 2002;49:1076-80. Sablotzki A, Hentschel T, Hofmann S, et al. Inhaled aerosolized iloprost in the evaluation of heart transplant candidates--experiences with 45 cases. J Clin Anesth 2006;18:108-13. Steinberg BA, Zhao X, Heidenreich PA, et al. Trends in patients hospitalized with heart failure and preserved left ventricular ejection fraction: prevalence, therapies, and outcomes. Circulation 2012;126:65-75. Shah AM, Claggett B, Sweitzer NK et al. Prognostic Importance of Impaired Systolic Function in Heart Failure With Preserved Ejection Fraction and the Impact of Spironolactone. Circulation. 2015;132(5):402-14. Voigt JU, Pedrizzetti G, Lysyansky P et al. Definitions for a common standard for 2D speckle tracking echocardiography: consensus document of the EACVI/ASE/Industry Task Force to standardize deformation imaging. Eur Heart J Cardiovasc Imaging. 2015;16(1):1-11. Wang J, Khoury DS, Thohan V, Torre-Amione G, Nagueh SF. Global diastolic strain rate for the assessment of left ventricular relaxation and filling pressures. Circulation. 2007;115(11):1376-83. Wu CK, Lee JK, Chiang FT, et al. Plasma levels of tumor necrosis factor-alpha and interleukin-6 are associated with diastolic heart failure through downregulation of sarcoplasmic reticulum Ca2+ ATPase. Crit Care Med 2011;39:984-92. Wu CK, Su MY, Lee JK et al. Galectin-3 level and the severity of cardiac diastolic dysfunction using cellular and animal models and clinical indices. Sci Rep. 2015;19;5:17007. Wu CK, Tsai HY, Su MM, et al. Evolutional change in epicardial fat and its correlation with myocardial diffuse fibrosis in heart failure patients. J Clin Lipidol 2017;11:1421-1431. Yurtseven N, Karaca P, Uysal G, et al. A comparison of the acute hemodynamic effects of inhaled nitroglycerin and iloprost in patients with pulmonary hypertension undergoing mitral valve surgery. Ann Thorac Cardiovasc Surg 2006;12:319-23. Yang H, Marwick TH, Fukuda N et al. Improvement in Strain Concordance between Two Major Vendors after the Strain Standardization Initiative. J Am Soc Echocardiogr. 2015;28(6):642-8 e7. Zegkos T, Parcharidou D, Ntelios D, Efthimiadis G, Karvounis H. The Prognostic Implications of Two-Dimensional Speckle Tracking Echocardiography in Hypertrophic Cardiomyopathy: Current and Future Perspectives. Cardiol Rev. 2018;26(3):130-6. | |
dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/52443 | - |
dc.description.abstract | 目的: 在保留性收縮分率心衰竭之病人,可觀察到運動時的肺微血管楔壓會顯著的上升。Iloprost是一種前列環素類似物,而前列環素路徑為造成肺動脈高壓之成因之一。此研究設計希望知道吸入式iloprost是否可增進病人之運動血液動力學及心臟儲備力。
方法: 此篇研究為雙盲隨機、安慰劑控制、平行設計之臨床試驗。共收錄34位保留性收縮分率心衰竭之病人。本研究將病人隨機分至兩組,分別接受iloprost及安慰劑治療,且於用藥前後的休息時及運動時,接受心導管檢查、呼出氣體檢測分析及二維心臟超音波檢查。主要評估指標為運動肺微血管楔壓之下降。高解析心臟超音波檢查包含左心室縱向形變、左心室舒張功能及右心室功能。 結果: 研究結果觀察到病人在運動時,肺微血管楔壓上升(from 16 (range, 14-23) mmHg to 27 (21-36) mmHg; p<0.0001)。與安慰劑相比,使用吸入式iloprost後,運動肺微血管楔壓明顯下降(adjusted mean: 20 (16-29) mmHg vs. 23 (17-32) mmHg; p = 0.002)。兩組之間的運動心輸出儲備並無顯著差異(0.2 (–1.3 - 1.2) L/min vs. –0.7 (–1.9 - 0.1) L/min; p=0.099)。與安慰劑相比,吸入式iloprost改善保留性收縮分率心衰竭病人運動時肺動脈壓與血流之關係。運動時,Iloprost組別的左心室整體縱向形變較明顯(-24.96 ± 1.20 vs. -20.75 ± 3.00, p<0.001),左心室整體縱向形變改變量亦較大(+6.02 ± 1.39 vs. +3.44 ± 0.80, p<0.001)。此外,使用iloprost也與改善運動時的左心室舒張功能及右心室收縮功能相關。 結論: 吸入式iloprost對於保留性收縮分率心衰竭之病人可有效增進運動時的血液動力學缺損。應進一步設計前瞻性臨床試驗研究iloprost之長期效能。 | zh_TW |
dc.description.abstract | Aims: A dramatic increase in pulmonary capillary wedge pressure (PCWP) during exercise is observed in patients with heart failure with preserved ejection fraction (HFpEF). The prostacyclin pathway is involved in pulmonary hypertension and iloprost is a prostacyclin analogue. This study was designed to determine whether iloprost inhalation could improve exercise hemodynamics and cardiac reserve in patients with HFpEF. Methods: Thirty-four HFpEF patients were enrolled in this double-blind, randomized, placebo-controlled, parallel-group trial. Patients received both cardiac catheterization and underwent expired gas analysis at rest, during exercise, and before and 15 minutes after treatment with either inhaled iloprost or placebo. The primary endpoint was decrease in exercise PCWP. In addition, two-dimensional transthoracic echocardiography with high temporal resolution was implemented to measure LV longitudinal strain, LV diastolic function and RV function both at rest and during supine exercise. Results: At baseline, enrolled patients showed an increase in PCWP during exercise (from 16 (range, 14-23) mmHg to 27 (21-36) mmHg; p<0.0001). After iloprost inhalation, exercise PCWP was significantly reduced compared to placebo (adjusted mean: 20 (16-29) mmHg vs. 23 (17-32) mmHg; p = 0.002). There was no difference for cardiac output reserve with exercise in two groups (0.2 (–1.3 - 1.2) L/min vs. –0.7 (–1.9 - 0.1) L/min; p=0.099). Iloprost improved the pulmonary artery pressure flow relationships in HFpEF with exercise compared to placebo. Left ventricular global longitudinal strain (LV GLS) during exercise increased more in iloprost group (LV GLS, -24.96 ± 1.20 vs. -20.75 ± 3.00, p<0.001). Iloprost also resulted in greater increment of LV GLS when exercise (ΔLV GLS, +6.02 ± 1.39 vs. +3.44 ± 0.80, p<0.001). Moreover, iloprost was associated with improvement of LV diastolic function, RV systolic function and pulmonary hypertension during exercise Conclusions: Iloprost inhalation improved hemodynamic deficits and myocardial performance during exercise in patients with HFpEF. Prospective trials testing long-term iloprost therapy in this population are warranted. | en |
dc.description.provenance | Made available in DSpace on 2021-06-15T16:14:57Z (GMT). No. of bitstreams: 1 U0001-0608202019010400.pdf: 1588384 bytes, checksum: a39efd3ace8d83693214a58a71a756d5 (MD5) Previous issue date: 2020 | en |
dc.description.tableofcontents | 口試委員會審定書……………………………………………………………… i 中文摘要………………………………………………………………………… ii 英文摘要…………………………………………………………………………. iii 第一章 緒論………………………………………………………………….. 1 第二章 研究方法與材料…………………………………………………….. 3 第三章 結果………………………………………………………………….. 8 第四章 討論………………………………………………………………….. 12 結論 ……………………………………………………………………………….. 17 參考文獻 …………………………………………………………………………. 18 圖 …………………………………………………………………………………….. 23 表 …………………………………………………………………………………….. 27 | |
dc.language.iso | en | |
dc.title | 吸入式Iloprost對於保留性收縮分率心衰竭病人之運動血液動力學及心室表現之影響 | zh_TW |
dc.title | Inhaled Iloprost, Exercise Hemodynamics, and Ventricular Performance in Heart Failure with Preserved Ejection Fraction–the ILO-HOPE trial | en |
dc.type | Thesis | |
dc.date.schoolyear | 108-2 | |
dc.description.degree | 碩士 | |
dc.contributor.coadvisor | 吳卓鍇(Cho-Kai Wu) | |
dc.contributor.oralexamcommittee | 林家齊(Chia-Chi Lin),鄭浩民(Hao-Min Cheng) | |
dc.subject.keyword | 保留性收縮分率心衰竭,血液動力學,運動負荷試驗,組織都卜勒影像,整體縱向形變,iloprost, | zh_TW |
dc.subject.keyword | heart failure with preserved ejection fraction,hemodynamics,iloprost,exercise stress test,tissue Doppler imaging,global longitudinal strain, | en |
dc.relation.page | 34 | |
dc.identifier.doi | 10.6342/NTU202002572 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2020-08-07 | |
dc.contributor.author-college | 醫學院 | zh_TW |
dc.contributor.author-dept | 臨床醫學研究所 | zh_TW |
顯示於系所單位: | 臨床醫學研究所 |
文件中的檔案:
檔案 | 大小 | 格式 | |
---|---|---|---|
U0001-0608202019010400.pdf 目前未授權公開取用 | 1.55 MB | Adobe PDF |
系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。