心脏衰竭与保存的喷射分数和心房动心脏衰竭
Thibault Lenormand1, Arnaud Bisson1,2, Laurent Fauchier3
1Service of Cardiology, Centre Hospitalier Universitaire Trousseau, Faculty of Medicine, François Rabelais University, Tours, France.
Minerva medica
|March 27, 2025
概括
保持喷射分数 (HFpEF) 的心力衰竭和心房动 (AF) 分享复杂的机制,使患者的预后恶化. 整体的管理策略对于这些相互交织的条件至关重要.
科学领域:
- 心脏病学 心脏病学
- 内部医学 内部医学
背景情况:
- 保持喷射分数 (HFpEF) 的心力衰竭和心房动 (AF) 是普遍存在的心血管疾病.
- 它们的同时出现显著增加了患者的发病率和死亡率.
- 了解它们共同的病理生理学对于有效的治疗至关重要.
研究的目的:
- 审查目前有关HFpEF和AF相关的病理生理学的证据.
- 检查这种关联对患者预后的影响.
- 讨论HFpEF和AF患者的治疗管理策略.
主要方法:
- 这项研究是对现有文献的叙述性审查.
- 综合了有关病理生理学,预后和治疗的证据.
主要成果:
- HFpEF和AF有共同的病理生理路径,包括炎症,左心房重塑,纤维化和心上脂肪组织的参与,导致左心房肌病.
- 任何一种情况的存在都会加剧另一种情况,使整体预后恶化.
- 作为HFpEF的基础治疗方法,SGLT2抑制剂显示出有前途,也有利于AF患者.
- 肌痛前列腺管理仍然复杂,基于CHA2DS2-VA得分的抗凝血是必不可少的,而节奏和节律控制策略在症状管理中是平衡的.
结论:
- HFpEF和AF具有复杂的,相互增强的病理生理学,这些病理生理学会对患者的结果产生负面影响.
- 目前关于并发性HFpEF和AF患者的特定治疗的数据有限.
- 建议采用整体和综合的治疗方法,以最好地照顾这些复杂的患者.
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