心力衰竭药物的使用和随访模式在移植接受者减少射分数:一个单一中心的经验
Michael C Hill1, Kaitlyn Legg2, Amer Ardati1
1Division of Cardiology, Department of Medicine, University of Illinois Chicago College of Medicine, Chicago, IL, USA.
International journal of cardiology. Heart & vasculature
|November 1, 2024
概括
移植后 (RT) 心力衰竭与减少喷射率 (HFrEF) 的药物治疗尚未研究. 很少有符合条件的患者接受了指导方针指导的氨酸- ангиотензин-阿尔多斯特抑制剂,这表明需要改善多学科护理.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心脏病学 心脏病学
- 移植医学 移植医学
背景情况:
- 在移植 (RT) 接受者中,心力衰竭与减少喷射分数 (HFrEF) 的管理尚未得到充分理解.
- 这项研究考察了在一个学术高等保健中心的后RT HFrEF医疗管理.
研究的目的:
- 描述移植后患者的HFrEF目前的医疗治疗实践.
- 识别护理方面的潜在缺口和改善管理的机会.
主要方法:
- 对具有HFrEF史的RT接受者的回顾性分析 (射出分数<40%).
- 收集的数据包括药物,功能,血压,心脏病随访和心声图,RT后长达2年.
- 根据功能和临床稳定性,评估对氨酸- ангиотензин- алдостерон抑制剂 (RAASi) 的适用性.
主要成果:
- 6.3%的RT接受者之前有过HFrEF诊断.
- 在RT后,β阻塞剂的使用量从92%降至76%,RAASi的使用量从49%降至27%.
- 心脏病随访率 (51%) 和心声回声图率 (38%) 都不够理想. 只有21%的符合条件的患者接受RAASi,包括那些射分数改善的患者.
结论:
- 在RT后的HFrEF患者中,观察到指南导向医疗疗的低最佳使用,特别是RAASi.
- 低心脏病随访率和心声回声图表明潜在的护理缺口.
- 加强心脏病学和移植团队之间的多学科合作对于优化这种高风险人群的护理至关重要.
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