秋水仙碱治疗射血分数保留型心力衰竭的研究进展

    Research progress of colchicine in the treatment of heart failure with preserved ejection fraction

    • 摘要: 射血分数保留型心力衰竭(HFpEF)是一种具有高发病率和高致死率的心衰综合征,其发病机制尚未完全阐明。全身慢性低度炎症被认为是HFpEF发生的基本病理机制,其促进心肌细胞僵化和心肌纤维化的发展。然而,HFpEF患者抗炎治疗尚未得到足够重视与研究。秋水仙碱是一种经典的抗炎药物,可抑制炎症小体激活与细胞因子(包括 IL-1β、hsCRP)的释放。秋水仙碱在冠状动脉疾病患者中的获益已得到充分证实,COLCOT与LoDoCo2大型研究结果显示,秋水仙碱可显著降低冠心病患者体内炎症水平与远期心血管事件的风险。然而,秋水仙碱在HFpEF治疗中研究十分有限,尚未得到重视。本文对现有临床与临床前研究证据进行归纳,旨在对秋水仙碱治疗HFpEF的应用前景进行综述与展望。

       

      Abstract: Heart failure with preserved ejection fraction(HFpEF) is a heart failure syndrome with high morbidity and mortality, and its pathogenesis has not been fully elucidated. Chronic low-grade systemic inflammation is considered to be the basic pathological mechanism of HFpEF, which promotes the development of cardiomyocyte stiffnessand myocardial fibrosis. However, anti-inflammatory treatment of HFpEF patients has not received enough attention and research. Colchicine is a classic anti-inflammatory drug that inhibits inflammasome activation and the release of cytokines, including IL-1β and hs-CRP. The benefits of colchicine in patients with coronary artery disease have been well established, and the results of COLCOT and LoDoCo2 studiesshowed that colchicine significantly reduced the level of inflammation and the risk of long-term cardiovascular events in patients with coronary heart disease. However, the research on colchicine in the treatment of HFpEF is very limited and has not received much attention. This article summarizes the existing clinical and preclinical research evidence, aiming to review and prospect the application prospect of colchicine in the treatment of HFpEF.

       

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