在心力衰竭中发现明显的表型集群 穿过射出分数谱:系统性审查
Claartje Meijs1,2, M Louis Handoko3, Gianluigi Savarese4
1Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
Current heart failure reports
|July 21, 2023
概括
本综述从34项研究中确定了9种不同的心力衰竭表型,强调了聚类作为临床分层的强有力的方法. 未来的研究应该专注于在临床试验和实践中实施这些表型.
科学领域:
- 心脏病学 心脏病学
- 生物信息学是一种生物信息学.
- 临床研究 临床研究
背景情况:
- 由于异质性,心力衰竭 (HF) 患者分层是复杂的.
- 聚类算法提供了一种数据驱动的方法来识别不同的患者子组.
- 了解HF表型对于个性化医学和临床试验设计至关重要.
研究的目的:
- 系统地审查和总结心力衰竭 (HF) 中现有的集群研究.
- 识别和描述来自集群分析的常见HF表型.
- 为未来的临床试验设计和常规临床实践实施提供指导.
主要方法:
- 在心力衰竭人群中采用聚类技术的研究进行系统的文献搜索.
- 对已识别的研究进行分析,以提取变量,方法和报告的集群/表型.
- 综合发现,以分类和描述不同的HF表型.
主要成果:
- 包括34项研究,其中19项专注于具有保留射出分数 (HFpEF) 的HF.
- 14个已识别的集群被分配给9个不同的表型,包括"年轻,低并发症负担"",代谢"",心"和"心房动 (AF) ".
- 在变量和技术中发现了显著的异质性,并提出了改善外部验证和透明度的建议.
结论:
- 聚类是一种强大的方法,用于发现临床上不同的心力衰竭表型.
- 确定了九个关键的表型,为患者分层提供了一个框架.
- 未来的努力应集中在开发可实施的临床实践和试验设计的表型模型上.
相关概念视频
Pathophysiology of Heart Failure
1.6K
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...
1.6K
Heart 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
Heart Failure II: Pathophysiology
16
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
16
Heart Failure III: Clinical Manifestations
24
Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...
24
Heart Failure I: Introduction
20
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...
20
Cardiomyopathy III: Hypertrophic Cardiomyopathy
16
Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
16


