患有心力衰竭和减少或保留射出分数的患者中风
Mingming Yang1,2, Toru Kondo1,3, Jawad H Butt1,4
1British Heart Foundation Cardiovascular Research Centre, University of Glasgow, 126 University Place, Glasgow G12 8TA, UK.
European heart journal
|June 26, 2023
概括
患有心力衰竭 (HF) 和中风病史的患者面临心血管风险增加. 在这个人群中解决未充分利用的治疗方法可以改善结果.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 公共卫生 公共卫生
背景情况:
- 脑卒中是心力衰竭 (HF) 患者的重要关注点,但不同射出分数之间的这些条件之间的相互作用是研究不足的.
- 这项研究调查了中风病史的患病率及其对减少喷射分数 (HFrEF) 和保持喷射分数 (HFpEF) 的HF患者的结果的影响.
研究的目的:
- 调查先前中风的患病率及其对心血管结局的影响,患者心力衰竭与减少喷射分数 (HFrEF) 和心力衰竭与保存喷射分数 (HFpEF).
主要方法:
- 通过使用来自七项临床试验的数据进行了个别患者的元分析.
- 这项研究包括20159名HFrEF患者和13252名HFpEF患者.
- 以往中风的患病率和复合心血管结局的发病率根据射出分数和中风史进行了分析.
主要成果:
- 8.3%的HFrEF患者和9.7%的HFpEF患者有中风病史.
- 以前的中风与增加的血管并发症和更糟糕的HF有关.
- 以前患有中风的患者心血管死亡,HF住院,中风或心肌梗塞的风险显著增加 (HR为HFrEF1.37,HR为HFpEF1.49).
- 在以前曾经中风的患者中,未来中风的风险翻了一番.
- 报告指出,在指导方针中推的治疗方法的使用不足,包括对心房的抗凝药,对动脉疾病的他类药物治疗和血压控制.
结论:
- 患有中风病史的心力衰竭患者有随后心血管事件的高风险.
- 在这个高危人群中,观察到对指导方针推的治疗方法 (抗凝药,他类药物,血压控制) 的使用不足.
- 针对这些治疗缺口可能会改善中风病史的HF患者的治疗结果.
更多相关视频
14:35Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs
Published on: April 17, 2021
8.6K
09:20Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
Published on: February 13, 2021
6.5K
相关概念视频
01:30Heart Failure IV: Classification and Diagnostic Evaluation
20
Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
20
01:30Heart Failure V: Medical Management
15
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
15
01:27Heart Failure I: Introduction
24
Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
24
01:17Pathophysiology of Heart Failure
1.7K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
1.7K
01:22Heart Failure VI: Adjunct Therapies
16
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
16
01:26Imbalances in Cardiac Output
1.4K
The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
1.4K