心脏衰竭中缺血性和非缺血性心肌病的区别 相关心脏性休克
Jason Feinman1, Matthew I Tomey1, Michael G Palazzolo2
1The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Journal of cardiac failure
|February 28, 2025
概括
与非缺血性心肌病 (NICM) 患者相比,患有缺血性心肌病 (ICM) 的心力衰竭相关心脏病性休克 (HF-CS) 的患者面临更高的死亡风险. ICM患者出现更多的并发症,需要更密集的干预措施,导致更差的结果.
科学领域:
- 心脏病学 心脏病学
- 关键护理医学 关键护理医学
- 心血管研究研究心血管研究
背景情况:
- 与心力衰竭相关的心脏性休克 (HF-CS) 是急症监护室入院的原因之一.
- 对于患有缺血性心肌病 (ICM) 和非缺血性心肌病 (NICM) 的HF-CS患者,存在有限的比较数据.
- 了解这些差异对于优化心脏重症监护病房患者护理和治疗结果至关重要.
研究的目的:
- 为了比较ICM和NICM HF-CS之间的患者特征,住院治疗和结果.
- 根据心肌病类型确定影响HF-CS患者死亡率的因素.
主要方法:
- 从重症监护心脏学试验网络注册表 (2017-2022) 的数据分析.
- 包括2463例高频-CS入院病例,不包括急性心肌梗塞或二次原因导致的病例.
- 多变量逻辑回归用于比较ICM和NICM组之间的住院死亡率.
主要成果:
- 在ICM患者中 (36.6%) 呈现出更多的并发症,先前心脏骤停和更高的器官衰竭得分.
- 在ICM患者中,机械通风和脏替代疗法的发生率更高.
- 尽管类似的临时支持使用,ICM患者心脏移植率较低,但持久的LVAD植入率相似.
结论:
- 由于HF-CS而入院的ICM患者通常比NICM患者更生病.
- 在ICM患者中,接受心脏移植的可能性较小.
- 缺血性心肌病独立地与HF-CS.患者在医院死亡率显著增加有关.
相关概念视频
01:17Pathophysiology of Heart Failure
1.5K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
1.5K
01:26Imbalances in Cardiac Output
1.4K
The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
1.4K
01:26Heart Failure Drugs: Inotropic Agents
545
Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
545
01:17Ischemic Heart Disease: Overview
1.2K
Ischemic heart disease occurs when the heart's blood supply dwindles, causing an ominous lack of oxygen and nutrients. This deficiency, stemming from reduced or obstructed blood flow, spells danger, leading to heart muscle damage and dysfunction.
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
1.2K
01:24Blood Pressure Imbalances and Circulatory Shock
762
Disorders affecting blood volume, vascular tone, or vascular function can disrupt vascular homeostasis, including conditions like hypertension, hemorrhage, and shock.
Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...
Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...
762
01:29Pathophysiology of Cardiac Performance
616
Typical heart performance is influenced by heart rate, rhythm, myocardial contraction, and metabolism or blood flow. The cardiac muscle exhibits distinct electrophysiological features, including pacemaker activity and calcium channel control, which play a vital role in the heart's response to various drugs. The autonomic nervous system, comprising the sympathetic and parasympathetic branches, regulates heart rate. Sympathetic activation increases heart rate, while parasympathetic activation...
616