Arnold J Malcolm O, Liu Peter, Demers Catherine, Dorian Paul, Giannetti Nadia, Haddad Haissam, Heckman George A, Howlett Jonathan G, Ignaszewski Andrew, Johnstone David E, Jong Philip, McKelvie Robert S, Moe Gordon W, Parker John D, Rao Vivek, Ross Heather J, Sequeira Errol J, Svendsen Anna M, Teo Koon, Tsuyuki Ross T, White Michel
University of Western Ontario, London, Canada.
Can J Cardiol. 2006 Jan;22(1):23-45. doi: 10.1016/s0828-282x(06)70237-9.
Heart failure remains a common diagnosis, especially in older individuals. It continues to be associated with significant morbidity and mortality, but major advances in both diagnosis and management have occurred and will continue to improve symptoms and other outcomes in patients. The Canadian Cardiovascular Society published its first consensus conference recommendations on the diagnosis and management of heart failure in 1994, followed by two brief updates, and reconvened this consensus conference to provide a comprehensive review of current knowledge and management strategies. New clinical trial evidence and meta-analyses were critically reviewed by a multidisciplinary primary panel who developed both recommendations and practical tips, which were reviewed by a secondary panel. The resulting document is intended to provide practical advice for specialists, family physicians, nurses, pharmacists and others who are involved in the care of heart failure patients. Management of heart failure begins with an accurate diagnosis, and requires rational combination drug therapy, individualization of care for each patient (based on their symptoms, clinical presentation and disease severity), appropriate mechanical interventions including revascularization and devices, collaborative efforts among health care professionals, and education and cooperation of the patient and their immediate caregivers. The goal is to translate best evidence-based therapies into clinical practice with a measureable impact on the health of heart failure patients in Canada.
心力衰竭仍然是一种常见的诊断疾病,尤其在老年人中。它仍然与显著的发病率和死亡率相关,但在诊断和管理方面已经取得了重大进展,并将继续改善患者的症状和其他预后。加拿大心血管学会于1994年发表了关于心力衰竭诊断和管理的首次共识会议建议,随后进行了两次简要更新,并重新召开了这次共识会议,以全面回顾当前的知识和管理策略。一个多学科的主要小组对新的临床试验证据和荟萃分析进行了严格审查,该小组制定了建议和实用提示,并由一个二级小组进行了审查。这份最终文件旨在为参与心力衰竭患者护理的专科医生、家庭医生、护士、药剂师及其他人员提供实用建议。心力衰竭的管理始于准确的诊断,需要合理的联合药物治疗、根据每位患者的症状、临床表现和疾病严重程度进行个体化护理、包括血运重建和器械在内的适当机械干预、医护人员之间的协作努力,以及患者及其直接护理人员的教育与合作。目标是将最佳的循证疗法转化为临床实践,对加拿大心力衰竭患者的健康产生可衡量的影响。