心力衰竭和二次心回:当代综述
Anton Camaj1, Vinod H Thourani2, Linda D Gillam3
1Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York.
概括
在心力衰竭 (HF) 患者中,二次腹 (SMR) 显著影响健康结果. 过导管边缘到边缘修复 (TEER) 为特定症状患者提供了改善的生存率和生活质量.
科学领域:
- 心脏病学 心脏病学
- 心血管医学 心血管医学
- 心脏衰竭管理的管理
背景情况:
- 二次心肌吐 (SMR) 是心力衰竭 (HF) 患者的一种严重并发症,与增加的发病率和死亡率有关.
- 最近心脏成像技术的进步改善了SMR的诊断和特征.
- 在HF中对SMR的治疗策略已经发生了显著的进化.
研究的目的:
- 审查目前对心力衰竭患者SMR的理解和管理.
- 突出不断发展的治疗选择,包括医疗,基于设备和外科手术的干预.
- 强调多学科方法对于最佳患者治疗结果的重要性.
主要方法:
- 对高频中SMR的当前文献和临床指导方针的审查.
- 分析使用心声回声,CT和MRI的诊断进步.
- 治疗策略的评估,包括指导方针导向的医疗疗法,心脏再同步疗法和跨导管中枢修复/更换.
主要成果:
- 以指导方针为导向的医学疗法仍然是管理潜在心肌病和血栓塞的基石.
- 心脏再同步治疗可以减少SMR,并改善选择的HF患者的结果.
- 过导管边缘到边缘修复 (TEER) 已经显示出对生存的好处,减少了HF住院,并改善了对医疗不耐药的症状患者的生活质量.
结论:
- 在高频中,SMR的最佳管理需要一个全面的,多学科的团队方法.
- 对于一些有症状的SMR患者来说,TEER是一种有效的选择,正在研究新兴的跨导管技术.
- 个性化治疗选择对于改善SMR高风险HF患者的预后至关重要.
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