心力衰竭与保存的喷射分数管理:临床实践指南和建议的系统审查
Adil Mahmood1,2, Eamon Dhall2, Christopher P Primus3
1William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK.
概括
本综述将心力衰竭与保存喷射分数 (HFpEF) 准则进行比较,在诊断方面达成共识,但在HFpEF管理的特定值和先进治疗策略方面存在差异.
科学领域:
- 心脏病学 心脏病学
- 临床实践指南 临床实践指南
- 系统审查是系统的审查.
背景情况:
- 存在多个心力衰竭的指导方针与保存的喷射分数 (HFpEF).
- 临床决策需要清楚地了解当前的建议.
- 由于其异质性,HFpEF管理面临着独特的挑战.
研究的目的:
- 系统地审查和分析现行国家和国际HFpEF诊断和管理在成年人的指南.
- 在领先的HFpEF指南中确定共识和差异的领域.
- 为帮助临床实践提供综合概述.
主要方法:
- 在MEDLINE和EMBASE数据库中进行系统的文献搜索 (截至2024年2月28日),查找过去10年出版的指南.
- 包括来自国家和国际医学组织的指导方针.
- 对7个严格的指导方针进行分析,重点关注HFpEF诊断,管理和治疗策略.
主要成果:
- 在HFpEF定义上存在共识,以及 natriuretic和心声回声学的诊断实用性.
- 在纳尿和心声学参数的诊断值中发现了差异.
- 关于一般药理/支持性护理的协议,但在表型特定的策略和监测频率上存在差异.
结论:
- 在HFpEF指导方针中,关于基础诊断要素和一般管理原则的达成一致.
- 在特定的诊断标准,先进的治疗方法和查建议方面仍然存在显著差异.
- 需要进一步的研究来解决表型识别和HFpEF新兴疗法的差异.
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