[心力衰竭的诊断与保存的喷射分数]
Deutsche medizinische Wochenschrift (1946)
|January 29, 2024
概括
保存喷射分数 (HFpEF) 的心力衰竭显著影响住院和患者预后. 通过心声学和NT-proBNP测试进行早期诊断对于管理这种不断增长的疾病至关重要.
科学领域:
- 心脏病学 心脏病学
- 内部医学 内部医学
背景情况:
- 保存喷射分数 (HFpEF) 的心力衰竭约占心力衰竭住院病例的50%.
- 诸如高血压,糖尿病和肥胖等风险因素的患病率增加,有助于提高HFpEF率.
- 高FpEF患者的预后与减少喷射分数患者一样严重,影响生活质量,发病率和死亡率.
研究的目的:
- 概述诊断方法来识别心力衰竭与保存的喷射分数.
- 突出早期发现和管理HFpEF的重要性.
- 讨论非侵入性和侵入性方法在确认HFpEF中的作用.
主要方法:
- 声心图对于对左心室缩,心肌放松受损和填充压力升高的非侵入性评估至关重要.
- 升高的NT-proBNP水平作为增加左心室壁应力和体积过载的生物标志物.
- 侵入性方法,包括右心脏或左心脏导管,测量肺毛细管压力 (PCWP) 和左心室末端透气压力 (LVEDP),当非侵入性测试没有确定性时.
主要成果:
- 诊断测试,引起的症状,如炼性呼吸障碍和运动不耐受,是确认或排除HFpEF的关键.
- 背脊缩,放松障碍和高填充压力的心声图发现表明HFpEF.
- 对PCWP或LVEDP的侵入性测量可提供HFpEF的最终确认.
结论:
- 对于表现出暗示HFpEF的症状的患者,需要及时进行诊断评估.
- 非侵入性成像和生物标记分析的组合,可能被侵入性压力测量所补充,对于准确的HFpEF诊断至关重要.
- 目前正在进行研究,以确定不同的HFpEF表型,以定制治疗策略.
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