心力衰竭中的多种疾病:利用集群分析指导量身定制的治疗策略
Mariëlle C van de Veerdonk1,2, Gianluigi Savarese3, M Louis Handoko2
1Department of Cardiology, Amsterdam University Medical Centers, Amsterdam Cardiovascular Sciences, University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands.
Current heart failure reports
|September 2, 2023
概括
治疗心力衰竭 (HF) 的疗效因患者表型而异. 虽然一些药物有利于所有减少喷射分数 (HFrEF) 患者,但其他药物对保留喷射分数 (HFpEF) 表型表现出特定效应,指导个性化HF治疗.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 内部医学 内部医学
背景情况:
- 心力衰竭 (HF) 是一种复杂的综合症,患者群体多样化.
- 在治疗中,区分具有保留喷射分数 (HFpEF) 和减少喷射分数 (HFrEF) 的HF至关重要.
- 现型聚类为个性化高频管理提供了一个潜在的框架.
研究的目的:
- 在心力衰竭中,审查不同患者表型集群中的治疗效果.
- 为了区分HFpEF与HFrEF患者组的治疗反应.
- 为了评估个性化HF治疗的表型导向方法的潜力.
主要方法:
- 对HF表型中治疗效应的现有文献进行系统审查.
- 对各种患者群体药物疗效的分析.
- 基于射出分数状态 (HFpEF与HFrEF) 的治疗结果的比较.
主要成果:
- ACE 抑制剂在 HFrEF 中显示出广泛的益处,在 HFpEF 中具有可变的效果.
- β抑制剂在HFrEF中有效,但在HFpEF中并不普遍,可能会使一些心脏病患者的结果恶化.
- 矿物质皮质类受体对抗剂在特定的HFpEF亚组 (年轻人,肥胖男性,代谢) 中表现出有利的影响.
结论:
- 在心力衰竭中,治疗反应依赖于表型.
- 一种以表型为导向的方法显示出个性化HF治疗策略的希望.
- 需要进一步的临床试验和现实世界的数据来完善和实施临床实践中的表型导向的HF治疗.
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