一个综合症,许多面孔:对心力衰竭现象的统一视角
Ioannis Paraskevaidis1,2, Elias Tsougos2, Christos Kourek1
1Medical School of Athens, National and Kapodistrian University of Athens, 15772 Athens, Greece.
International journal of molecular sciences
|September 27, 2025
概括
心力衰竭 (HF) 是一个单一的频谱,而不是不同的综合征. 所有心力衰竭表型都有共同的机制,这表明需要采用统一的诊断和治疗方法.
科学领域:
- 心脏病学 心脏病学
- 病理生理学 病理生理学
- 翻译医学是一种翻译医学.
背景情况:
- 心力衰竭 (HF) 传统上根据左心室喷射分数 (EF) 将其分为减少的 (HFrEF),轻度减少的 (HFmrEF) 和保存的 (HFpEF) 现型.
- 基于EF的分类虽然实用,但由于临床试验中的定义不一致和类别模糊而面临挑战.
- 这种模糊性阻碍了对心力衰竭的准确诊断和有针对性的治疗策略.
研究的目的:
- 挑战传统的基于EF的心力衰竭表型.
- 提出一个统一的,机械驱动的心力衰竭模型作为一个单一的实体,具有可变的表现.
- 探索所有HF表型中共同的病理生理机制.
主要方法:
- 关于心力衰竭病理生理学和临床分类的现有文献的全面审查.
- 对涉及不同高频表型的分子,细胞和系统机制的分析.
- 综合证据支持基于心力衰竭的频谱模型.
主要成果:
- 新出现的数据表明,在所有高频表型中,无论EF如何,都有共同的潜在机制.
- 常见的途径包括神经激素激活,炎症,线粒体功能障碍,纤维化和亡.
- 传统的EF类别可能不准确地反映出不同的病理生理实体.
结论:
- 心力衰竭应该被视为一种单一的临床综合征,其表现在频谱上有所不同.
- 一个统一的,机械驱动的模型可以提高高频的诊断精度和治疗向性.
- 基于共享机制,而不是EF分层的HF研究的重构对于推进治疗至关重要.
相关概念视频
01:17Pathophysiology of Heart Failure
2.9K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
2.9K
01:30Heart Failure IV: Classification and Diagnostic Evaluation
321
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...
321
01:29Heart Failure II: Pathophysiology
730
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
730
01:27Heart Failure I: Introduction
707
Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
707
01:26Heart Failure III: Clinical Manifestations
510
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...
510
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy
411
Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
411