通过保存的喷射小部分解决心力衰竭的诊断困境
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
概括
由于病理生物学不清楚,对心力衰竭与保留射出分数 (HFpEF) 的定义缺乏共识. 本综述提出了诊断方法,并强调了对准确的HFpEF识别和治疗的研究需求.
科学领域:
- 心脏病学
- 医疗诊断
背景情况:
- 没有统一的定义,阻碍了诊断和治疗.
- 各指南的诊断标准反映了对HFpEF病理生物学和异质性的不完全理解.
研究的目的:
- 审查目前对HFpEF的知识缺口和诊断工具.
- 提出HFpEF诊断的实用方法,并确定未来的研究重点.
主要方法:
- 对HFpEF诊断标准,病理生物学和自然史的现有文献的审查.
- 分析当前的诊断工具和算法.
- 考虑对运动不耐受性的先进和挑性测试.
主要成果:
- 在休息阻塞的住院患者中,诊断更加直接.
- 在运动不耐受患者中,诊断是复杂的,可能需要在运动期间进行血液动力学评估.
- 迫切需要准确和可行的HFpEF诊断工具.
结论:
- 标准化HFpEF定义对于诊断,临床试验招生和治疗开发至关重要.
- 未来的研究应集中在动物模型和人体研究上,以阐明HFpEF的病理生物学,并开发新的诊断方法.
- 准确的HFpEF定义最终将改善患者的结果.
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