心力衰竭综合征:不同疾病的不同定义 - 我们是否需要单独的指导方针? 一个叙事审查
1Columbus Clinic Center, Via Buonarroti 48, 20145 Milan, Italy.
Journal of clinical medicine
|July 29, 2025
概括
目前基于左心室喷射率 (LVEF) 的心力衰竭 (HF) 分类受到争议. 修订后的LVEF方法和轨迹分析可能会改善HF管理和患者的治疗结果.
科学领域:
- 心脏病学 心脏病学
- 临床医学 临床医学
- 医学诊断 医学诊断 医学诊断
背景情况:
- 心力衰竭 (HF) 是死亡的主要原因,对患者造成重大负担和经济影响.
- 目前的HF分类依赖于左心室喷射分数 (LVEF) 分为HFrEF,HFmrEF和HFpEF等子组.
- 新兴的表型 (HFimpEF,HFsnEF) 增加了复杂性,但LVEF值仍在争论中,测量的可靠性也受到质疑.
研究的目的:
- 批判性地评估目前基于LVEF的高频分类系统.
- 探索单个LVEF测量在HF诊断和管理中的局限性.
- 建议修订HF分类框架,重点关注LVEF轨迹和修订的值.
主要方法:
- 这篇叙事综述综合了关于高频分类和LVEF的当前文献.
- 它分析了围绕现有的LVEF门的挑战和辩论.
- 它讨论了考虑LVEF趋势而不是单个测量的潜在好处.
主要成果:
- 对于高频分类的现有的LVEF值显示出重要的专家间变化和可靠性问题.
- 高FpEF患者是一个异质的群体,具有挑战性的统一管理.
- 在LVEF测量中的观察者内部和观察者间的变化使准确的HF分组复杂化.
结论:
- 需要一种新的HF分类方法,可能会修订LVEF参考值.
- 强调LVEF轨迹而不是单个测量可能会改善患者分层.
- 简化分类 (例如,HF降低EF≤40%,低于正常EF41-55%,正常EF>55%) 可能有助于临床管理.
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