心不全の診断上のジレンマを保存されたエジェクション分数で解決する
Jennifer E Ho1,2,3, Margaret M Redfield4, Gregory D Lewis1,3
1Corrigan Minehan Heart Center (J.E.H., G.D.L.), Massachusetts General Hospital, Harvard Medical School, Boston.
Circulation
|November 2, 2020
まとめ
保存されたエジェクション分数 (HFpEF) による心不全の定義は,病理学が明確でないため,コンセンサスが欠けている. このレビューでは,診断アプローチを提案し,HFpEFの正確な識別と治療のための研究ニーズを強調しています.
科学分野:
- 心臓病科
- 医療診断
背景:
- 発射分子が保存された心不全 (HFpEF) は統一された定義がなく,診断と治療を妨げています.
- ガイドラインの診断基準の多様性は,HFpEFの病理学と異質性の不完全な理解を反映しています.
研究 の 目的:
- HFpEFに関する現在の知識のギャップと診断ツールを検討する.
- HFpEF診断の実践的なアプローチを提案し,将来の研究優先事項を特定する.
主な方法:
- HFpEFの診断基準,病理学,自然史に関する既存の文献のレビュー.
- 現在の診断ツールとアルゴリズムの分析
- 運動不耐性に対する高度な挑発的な検査を検討する.
主要な成果:
- 休息中の閉塞で入院した患者では診断がより簡単です.
- 運動不耐症の患者の診断は複雑で,運動中に血液動力学的評価が必要になる可能性があります.
- HFpEFの正確で実行可能な診断ツールが緊急に必要です.
結論:
- HFpEFの定義を標準化することは,診断,臨床試験の登録,治療開発に不可欠です.
- 将来の研究は動物モデルとヒトの研究に焦点を当てて,HFpEFの病理生物学を明らかにし,新しい診断方法を開発する必要があります.
- HFpEFの正確な定義は,最終的に患者のアウトカムを改善します.
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