心脏衰竭与保存的喷射分数:诊断,风险评估和治疗
Stephan von Haehling1,2, Birgit Assmus3, Tarek Bekfani4
1Department of Cardiology and Pneumology, University of Göttingen Medical Center, Robert-Koch-Strasse 40, 37075, Göttingen, Germany. stephan.von.haehling@web.de.
概括
保存喷射分数 (HFpEF) 的心力衰竭有多种原因,需要仔细诊断. 目前的指导方针为HFpEF管理提供了不同的治疗建议.
科学领域:
- 心脏病学 心脏病学
- 内部医学 内部医学
背景情况:
- 由于其异构的病因,心力衰竭与保存的喷射分数 (HFpEF) 构成了复杂的临床挑战.
- 高FpEF经常与多种并发症共存,包括心房动,糖尿病,慢性脏病,膜性心脏病,缺铁和肉类.
研究的目的:
- 提供对目前对HFpEF诊断,临床评估和治疗策略的理解的全面概述.
- 突出欧洲和美国指南之间的诊断算法和治疗建议的差异.
主要方法:
- 审查当前的欧洲和美国心力衰竭指南.
- 对HFpEF的诊断标准的分析,包括成像技术和左心室填充压力的评估.
- 对治疗建议的评估,包括-葡萄糖共运输体2抑制剂,氨酸- ангиотензин-阿尔多斯特轴抑制剂和β-抑制剂.
主要成果:
- 诊断HFpEF需要评估心脏功能障碍和左心室填充压力的升高,使用直接测量或像尿素等代理.
- 指导方针提出了不同的算法,通过结合相关并发症的管理来完善HFpEF诊断.
- 治疗策略显示出差异,-葡萄糖共传输体2抑制剂的确立证据,但对- ангиотензин-阿尔多斯特轴抑制剂的建议各不相同,并且除了特定的并发症外,一般不鼓励使用β-阻断剂.
结论:
- 高风环境环境环境管理需要采用多方面的方法,考虑到其复杂的病因和并发症.
- 坚持指导方针导向的评估和治疗至关重要,承认当前的治疗差异.
- 进一步的研究可能有助于调和不同的治疗建议,并优化HFpEF患者的治疗结果.
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