Department of Cardiology, Hull York Medical School, Castle Hill Hospital, University of Hull, Daisy Building, Cottingham, Kingston-upon-Hull, UK.
Eur J Heart Fail. 2011 Jul;13(7):805-8. doi: 10.1093/eurjhf/hfr077.
This article provides information and a commentary on key trials relevant to the pathophysiology, prevention, and treatment of heart failure (HF) presented at the annual American College of Cardiology meeting held in New Orleans in 2011. Unpublished reports should be considered as preliminary, since analyses may change in the final publication. The STICH trial failed to show a benefit of revascularization on all-cause mortality in patients with HF and coronary artery disease; however, cardiovascular deaths were reduced compared with medical therapy alone. Results from the NorthStar study suggest that patients with clinically stable systolic HF, who are on optimal medical therapy, including those with elevated amino-terminal B-type natriuretic peptide levels, may not benefit from long-term follow-up in an HF clinic. Results from the TARGET study demonstrate that targeted left ventricular lead placement using speckle tracking echocardiography is feasible in patients undergoing implantation of a cardiac resynchronization therapy device and is associated with an enhanced response. Two-year follow-up data from EVEREST II show that although a catheter-based mitral valve repair procedure using the MitraClip(®) system was less effective at reducing mitral regurgitation than conventional surgery, similar improvements in clinical outcomes were observed with fewer short-term adverse events.
本文提供了 2011 年在美国新奥尔良举行的美国心脏病学会年会上介绍的与心力衰竭（HF）的病理生理学、预防和治疗相关的关键试验的信息和评论。未发表的报告应视为初步报告，因为最终发表的分析可能会发生变化。STICH 试验未能显示血运重建对伴有冠状动脉疾病的心力衰竭患者全因死亡率的益处；然而，与单纯药物治疗相比，心血管死亡人数有所减少。NorthStar 研究的结果表明，在最佳药物治疗的基础上，包括氨基末端 B 型利钠肽水平升高的患者，临床稳定的收缩性心力衰竭患者可能不会从 HF 诊所的长期随访中获益。TARGET 研究的结果表明，在接受心脏再同步治疗装置植入的患者中，使用斑点追踪超声心动图进行靶向左心室导联放置是可行的，并且与增强的反应相关。EVEREST II 的两年随访数据表明，尽管使用 MitraClip（®）系统的基于导管的二尖瓣修复术在减少二尖瓣反流方面的效果不如传统手术，但观察到与短期不良事件较少相关的临床结局相似的改善。
