回到基础:需要对慢性心力衰竭的病因学分类
Filippos Triposkiadis1, Andrew Xanthopoulos2, Stavros G Drakos3
1School of Medicine, European University Cyprus, Nicosia 2404, Cyprus; Department of Cardiology, University Hospital of Larissa, Larissa 41110, Greece.
Current problems in cardiology
|February 12, 2024
概括
对于心力衰竭 (HF) 的传统左心室喷射分数 (LVEF) 分类已经过时了. 新的证据表明,以病因学为导向HF治疗和精准医学的方法更好.
科学领域:
- 心脏病学 心脏病学
- 心脏衰竭研究研究
- 临床医学 临床医学
背景情况:
- 左心室喷射分数 (LVEF) 长期以来一直是心力衰竭 (HF) 的分类和管理的核心.
- 这种分类受到青,因为它确定了从特定治疗中受益的患者群体.
研究的目的:
- 审查质疑LVEF在高频分类中的有用性的证据.
- 倡导转向当代概念指导慢性HF治疗.
主要方法:
- 审查目前关于LVEF在HF分类和治疗指南中的证据.
- 分析LVEF在指导医疗,器械和机械循环支持疗法的局限性.
- 关于另一种病因学HF分类的建议.
主要成果:
- 基于LVEF的HF分类的逻辑已经减弱,因为神经激素抑制剂有利于大多数HF患者,无论LVEF如何.
- LVEF对于 implantable cardioverter-defibrillators 和心脏再同步治疗等设备治疗的预测能力很差.
- 在LV辅助器件植入中,LVEF是LV尺寸的不足替代品.
结论:
- 在HF分类和治疗指南中依赖LVEF越来越无法维持.
- 根据流行病学数据,建议过渡到基于流行病学数据的病因性HF分类.
- 这种新分类将支持HF精密医学的高分辨率表型化.
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