在心力衰竭中冠状动脉疾病
Ryohei Ono1, Luiz Menezes Falcão2
1Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan; British Heart Foundation Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom.
The American journal of cardiology
|August 27, 2025
概括
冠状动脉疾病 (CAD) 显著导致心力衰竭与保存的射出分数 (HFpEF). 鉴定缺血表型对于更好的风险评估和治疗策略至关重要.
科学领域:
- 心脏病学
- 心脏衰竭的研究
- 缺血性心脏病
背景情况:
- 冠状动脉疾病 (CAD),包括表心和微血管功能障碍 (CMD),是心力衰竭的主要因素.
- 心脏病的存在与不良结果,心肌重塑和进展到减少的喷射分数相关.
- 冠状动脉微血管功能障碍 (CMD) 在女性中更为常见,影响心肌输液和能量,导致运动不耐受和增加填充压力.
研究的目的:
- 突出出缺血表型在心力衰竭中具有保留的喷射分数 (HFpEF) 的重要性.
- 强调冠状动脉疾病 (CAD) 在HFpEF病理生理学和结果中的作用.
- 讨论HFpEF中CAD的诊断和治疗方面的考虑.
主要方法:
- 对冠状动脉疾病 (CAD) 和心力衰竭 (HFpEF) 的当前文献的综述.
- 对患有缺血的HFpEF表型进行SGLT2抑制剂和芬瑞等新兴治疗方法的讨论.
- 强调多式诊断技术来识别亚临床CAD和CMD.
主要成果:
- 冠状动脉疾病 (CAD) 是HFpEF的关键驱动因素,与预后不佳和疾病进展有关.
- 冠状动脉微血管功能障碍 (CMD) 特别影响心脏功能,并导致运动不耐受等症状.
- 新型疗法在各种HFpEF类型中表现有前途,包括缺血组分.
结论:
- 在HFpEF中识别缺血模式对于准确的风险分层和指导治疗决策至关重要.
- 多模式诊断对于检测CMD和亚临床CAD至关重要.
- 未来的研究应探索表型特定的方法,以提高异质HFpEF群体的结果.
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