Fischer D, Dettmer-Flügge A, Thiesemann R, Gogol M
Klinik für Kardiologie und Angiologie, Zentrum Innere Medizin, Medizinische Hochschule Hannover, Carl-Neuberg-Strasse 1, Hannover, Germany.
Z Gerontol Geriatr. 2011 Jun;44(3):158-65. doi: 10.1007/s00391-011-0197-y.
The incidence of chronic heart failure rises with increasing age as does the proportion of diastolic dysfunction in comparison to heart failure with reduced systolic ejection fraction. Symptoms are less specific, such as fatigue, which makes a diagnosis more difficult but classification and diagnostic work-up are the same as in younger patients. Regarding therapy there is less data because the typical study population does not include geriatric patients with multimorbidity. Nevertheless ACE inhibitors, angiotensin receptor blockers, aldosterone antagonists, diuretics and digoxin should also be used in geriatric patients considering indications and contraindications and especially interactions with co-morbidities and other prescribed medication on an individual basis. The numbers of patients above the age of 75 years receiving heart surgery is increasing. Current scores often overestimate the risk of an operation even though after individual stratification surgical and interventional procedures can be performed with low risk.
慢性心力衰竭的发病率随年龄增长而上升，与收缩期射血分数降低的心力衰竭相比，舒张功能障碍的比例也是如此。症状不那么具有特异性，如疲劳，这使得诊断更加困难，但分类和诊断检查与年轻患者相同。关于治疗的数据较少，因为典型的研究人群不包括患有多种疾病的老年患者。然而，考虑到适应症和禁忌症，特别是与合并症和其他处方药物的个体相互作用，老年患者也应使用血管紧张素转换酶抑制剂、血管紧张素受体阻滞剂、醛固酮拮抗剂、利尿剂和地高辛。接受心脏手术的75岁以上患者数量正在增加。目前的评分往往高估了手术风险，尽管在进行个体分层后，手术和介入程序可以低风险进行。
