目前的实践和新兴疗法,以优化心脏衰竭在心脏沙丘病的管理:一个系统的审查
Aadi R Palvia1, Avneet Kaur1, Gibran A Azeez2,1
1Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Cureus
|September 10, 2024
概括
治疗心脏类瘤 (CS) 需要使用皮质类固醇和免疫抑制剂来控制炎症并预防心力衰竭 (HF). 晚期病例可能需要心脏移植,但对CS诱导的高血压的最佳治疗策略需要进一步研究.
科学领域:
- 心脏病学 心脏病学
- 免疫学 免疫学 免疫学
- 类风湿病学 类风湿病学
背景情况:
- 心脏沙尔科毒症 (CS) 是一种炎症性疾病,导致心律失常,心力衰竭 (HF) 和心脏突然死亡.
- 诊断依赖于成像 (心声图,MRI,FDG-PET) 和内心肌活检.
- 目前的治疗包括皮质类固醇,免疫抑制剂和心脏移植 (HTx).
研究的目的:
- 系统地审查最近 (2019-2024) 关于沙尔科病患者心力衰竭的文献.
- 综合当前关于心脏沙尔科毒性诱导心脏HF的诊断和管理的证据.
- 识别知识缺口和未来研究领域.
主要方法:
- 按照PRISMA 2020指南进行系统审查.
- 搜索了PubMed,谷歌学者和科学直接数据库.
- 包括来自最初36755篇文章的11项质量评估研究.
主要成果:
- 皮质类固醇是第一线治疗,往往成功地控制了CS进展.
- 免疫抑制剂 (例如,甲基酸盐,阿扎西奥普林) 减轻长期使用类固醇.
- 生物制剂,高风湿管理药物,LVAD和HTx是耐火或末期疾病的选择.
结论:
- 对CS诱导的HF的治疗策略各不相同,其中皮质类固醇是主要的.
- 由于有限的标准化协议和知识,最佳管理仍在争论中.
- 进一步的研究和临床试验至关重要,以改善心脏沙丘病症患者的治疗结果.
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