V-HEFT I研究PPT课件.ppt

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1、EffectofVasodilatorTherapyonMortalityinChronicCongestiveHeartFailureResultsofaVeteransAdministrationCooperativeStudy(V-HEFTI)Multicenter,randomized,double-blind,placebo-controlledtrial642menfollowedforanaverageof2.3yearsPatientHistory:Menwithimpaired

2、cardiacfunctionandreducedexercisetoleranceAllpatientsweretakingdigoxinanddiureticsInadditiontomortality,thefollow-updataincludedEF,exercisetoleranceandechocardiographyNEnglJMed1986;314:1547-52V-HEFTIObjectivesToevaluatetheeffectsofvasodilatortherapy

3、onmortalityamongpatientswithchroniccongestiveheartfailure,impairedcardiacfunctionandreducedexercisetolerancewhoweretakingdigoxinanddiureticsPatientswererandomizedtodouble-blindtreatmentwithplacebo,prazosin(20mgperday),orthecombinationofhydralazine(30

4、0mgperday)andisosorbidedinitrate(160mgperday)NEnglJMed1986;314:1547-52V-HEFTICumulativeMortalityfromtheTimeofRandomizationintheThreeTreatmentGroupsNEnglJMed1986;314:1547-52V-HEFTIResultsMortalityovertheentirefollow-upperiodwaslowerintheHyd-Isogroup

5、vs.placebo.ThedifferencewasofborderlinestatisticalsignificanceRiskreductionattwoyearsintheHyd-Isogroupwas34%(p=0.028)RiskreductionatthreeyearsintheHyd-Isogroupwas36%MortalityintheprazosingroupwassimilartoplaceboEFrosesignificantlyateightweeksandatone

6、yearintheHyd-Isogroupbutnotintheplaceboorprazosingroups.NEnglJMed1986;314:1547-52V-HEFTIConclusion“Thedatasuggeststhattheadditionofhydralazineandisosorbidenitratetothetherapeuticregimenofdigoxinanddiureticsinpatientswithchroniccongestiveheartfailure

7、canhaveafavorableeffectonleftventricularfunctionandmortality”NEnglJMed1986;314:1547-52