加拿大心血管学会/加拿大心力衰竭学会2025年心力衰竭的药理管理指南更新,心力衰竭的非减小射出分数 (LVEF>40%)
Sean Virani1, Shelley Zieroth2, Natasha Aleksova3
1University of British Columbia, Vancouver, British Columbia, Canada.
The Canadian journal of cardiology
|October 19, 2025
概括
无减排分数 (HFnrEF) 的心力衰竭越来越常见. 新的指导方针统一了LVEF>40%的HFnrEF患者的治疗,建议使用关键药物来改善结果并减少住院治疗.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 临床指南 临床指南
背景情况:
- 带有非减小喷射率 (HFnrEF) 的心力衰竭,以左心室喷射率 (LVEF) >40%为特征,是一个日益严重的临床问题.
- 从历史上看,这组患者被划分为轻度减轻的高频率肺炎 (HFmrEF) 或保存喷射分数的高频率肺炎 (HFpEF),导致治疗中的潜在模两可.
- 新出现的证据表明,在LVEF>40%的频谱中,临床结果和治疗反应一致.
研究的目的:
- 为症状性HFnrEF的药理管理提供统一的临床框架和指导方针.
- 减少决策中的模两可,并促进对HFnrEF.基于证据的疗法的一致应用.
- 支持临床医生将证据转化为实践,以改善患者的福祉.
主要方法:
- 基于推评级,评估,开发和评估 (GRADE) 方法的指导方针建议的制定.
- 包括聚焦于药物治疗的元分析,这些药物疗法已被证明可以减少HF住院治疗 (HFH) 并提高患者的福祉.
- 专注于四个关键类型的药理疗法:SGLT2抑制剂 (SGLT2i),MRA,RNAI和GLP-1受体激动剂.
主要成果:
- 该指南为HFnrEF的药理治疗提供了简明的建议.
- 提供了关于启动,定位和维持基础治疗的实用技巧.
- 重点是整个LVEF>40%频谱的治疗一致性.
结论:
- 采用HFnrEF术语简化了临床决策,并促进了标准化的护理.
- 在HFnrEF频谱中一致应用指南导向的医疗疗可以简化护理途径.
- 本指南旨在加强在现实环境中为症状性HFnrEF提供有效的医疗治疗.
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