护理提供者之间的心力衰竭与保存喷射分数管理之间的差异:一项国际调查
Federica Guidetti1, Clara Inés Saldarriaga Giraldo2, Anastasia Shchendrygina3
1Division of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
European journal of heart failure
|August 22, 2024
概括
随着医生专业的不同,心力衰竭的诊断和治疗有着保存的射出分数 (HFpEF) 显著不同. 非心脏病学家和一般心脏病学家不太可能使用关键诊断工具,增加HFpEF诊断不足和治疗不足的风险.
科学领域:
- 心脏病学 心脏病学
- 内部医学 内部医学
- 临床研究 临床研究
背景情况:
- 保存喷射分数 (HFpEF) 的心力衰竭是一个日益增长的临床挑战,具有显著的发病率和死亡率.
- 大多数HFpEF患者接受非心脏病学家的护理,因此需要在各种医学专业领域实施有效的管理策略.
- -葡萄糖共运输体2抑制剂 (SGLT2i) 的出现强调了在初级保健机构中需要准确的HFpEF识别和治疗的需要.
研究的目的:
- 评估和比较不同医生专业的HFpEF管理,包括心脏病专家,HF专家和非心脏病专家.
- 在各种医疗群体中识别HFpEF的诊断方法和治疗策略的差异.
- 评估医生专业对采用当前指南和HFpEF新兴疗法的影响.
主要方法:
- 从2023年5月到7月进行了一项全球独立的基于网络的调查,收集了来自95个国家的1460名医生的数据.
- 参与者被分为高频率专家 (20%),心脏病专家 (65%) 和非心脏病专家 (15%).
- 后期分析比较了各专业组的诊断工作,治疗偏好和药物选择.
主要成果:
- 非心脏病学家和心脏病学家比HF专家使用尿素和HFpEF评分进行诊断的可能性要低得多,并且对特定的回声心脏病学参数的访问或考虑较少.
- 在所有专业 (<30%) 中,腹筋应激测试很少使用.
- 虽然SGLT2i和利尿剂是首选药物,但其他关键HF药物的处方模式有所不同,在选择SGLT2i作为单一药物方面存在显著差异,并且显著比例的非HF专家认为β-阻断剂是第一线治疗.
结论:
- 在基于医生专业的HFpEF诊断和治疗管理中存在实质性的差异.
- 非高频专家表明,他们较少使用推的诊断工具,这可能导致高频pEF的诊断不足和治疗不足.
- 这些发现突出了HFpEF护理中的关键差距,需要有针对性的教育和临床干预来改善患者的治疗结果.
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