缺铁导致心力衰竭:从ESC指南到罗马尼亚医院的临床实践
Oana Sirbu1,2, Andreea Tirnoveanu2, Raluca Ecaterina Haliga1,2
1Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 16 University Street, 700115 Iasi, Romania.
Biomedicines
|September 27, 2025
概括
尽管心力衰竭 (HF) 中铁缺乏症 (ID) 的查率很高,但只有25.5%的符合条件的患者接受了静脉铁补充剂 (IS). 这突显了欧洲心脏病学会 (ESC) 对高压管理的指导方针的落实方面的差距.
科学领域:
- 心脏病学 心脏病学
- 内部医学 内部医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 缺铁 (ID) 是心力衰竭 (HF) 的常见并发症,对功能能力和预后产生负面影响.
- 欧洲心脏病学会 (ESC) 的指导方针主张在HF患者中进行系统的ID查和静脉注射铁补充剂 (IS).
- 目前的临床实践显示,这些基于证据的建议的遵守程度有限.
研究的目的:
- 评估ESC对住院HF患者的ID查和IS指南的实施情况.
- 评估ID诊断率和随后的静脉注射IS治疗率.
- 为了确定与接受IS相关的患者特征.
主要方法:
- 在2018年1月至2022年9月期间,对4348名住院高风患者 (NYHA II-IV) 进行了回顾性观察研究.
- 从电子医疗记录中收集的数据包括人口统计数据,并发病症,实验室结果和心声回声检查结果.
- 静脉静脉注射被定义为血清费里丁<100 ng/mL和铁性碳体糖的使用.
主要成果:
- 超过58%的HF患者进行了ID查,42.8%被诊断为绝对缺乏症.
- 只有25.5%的ID确诊患者接受了静脉注射的IS (铁碳肉糖糖).
- 接受IS治疗的患者主要是老年人,女性,患有缺血性或膜性心脏病;他们还呈现出较高的NT-proBNP和热素水平.
结论:
- 在推的ID查/治疗和HF的实际临床实践之间存在很大的差距.
- 尽管查率很高,但只有不到四分之一的符合条件的HF患者接受静脉注射IS.
- 更好地遵守ESC指南对于优化ID的HF患者的治疗结果至关重要.
更多相关视频
14:35Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs
Published on: April 17, 2021
05:35A Point-of-Care Method with Integrated Decision Support Tool to Estimate Anemia at Population Level
Published on: January 19, 2024
相关概念视频
01:26Heart Failure III: Clinical Manifestations
Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...
01:30Heart Failure IV: Classification and Diagnostic Evaluation
Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
01:30Heart Failure V: Medical Management
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
01:22Heart Failure VI: Adjunct Therapies
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
01:30Heart Failure VII: Nursing Interventions
The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
01:29Cardiomyopathy V: Interprofessional Care
Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...