心力衰竭的异质性与保存的喷射分数:表型分类和临床影响的系统审查
1Internal Medicine Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, 08208 Sabadell, Spain.
Journal of clinical medicine
|July 29, 2025
概括
保存喷射分数 (HFpEF) 的心力衰竭是复杂而异质的. 使用数据驱动方法识别不同的患者表型可以指导个性化治疗并改善结果.
科学领域:
- 心脏病学 心脏病学
- 精准医学是一门精准的医学.
- 数据科学数据科学数据科学
背景情况:
- 由于心力衰竭的异质性和缺乏向治疗方法,心力衰竭与保存的喷射分数 (HFpEF) 构成了重大挑战.
- 目前仅基于射出分数的分类忽视了关键的生物和临床差异,影响了试验结果和患者护理.
研究的目的:
- 使用数据驱动的方法系统地审查识别不同的HFpEF表型的研究.
- 探索已识别的HFpEF表型之间的临床影响,预后价值和治疗应答变异.
主要方法:
- 对20项研究 (2010-2025) 的系统审查,重点关注HFpEF表型分类策略.
- 对人口统计,临床,血液动力学和生物标志物数据的分析,以确定反复出现的表型.
主要成果:
- 确定了几种反复出现的HFpEF表型,包括代谢肥胖,虚弱老年人,心房动主导,心脏和肺高血压/右心.
- 这些表型表现出不同的病理生理机制和风险概况,这表明当前通用治疗方法的局限性.
- 现型化中的方法挑战包括不一致的变量,缺乏验证,以及有限的现实世界数据集成.
结论:
- 对于HFpEF来说,转向表型导向管理的范式转变至关重要,超越了基于射出分数的分类.
- 精准医学方法,利用标准化表型和多组数据,可以个性化治疗和改善临床试验设计.
- 未来的方向包括开发强大的表型化算法和实施表型分层临床试验,以获得更好的患者结果.
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