Ashraf O, Sharif H
Department of Cardiothoracic Surgery, The Prince Charles Hospital, Chermside, Queensland, Australia -
J Cardiovasc Surg (Torino). 2015 Aug;56(4):661-9. Epub 2013 May 29.
Cardiac failure remains a significant source of morbidity and mortality worldwide. Multiple treatment options exist and have variable safety and reliability. Stem cell grafting and left ventricular assist device implantation are two of the promising recent techniques that have a bright future as transient and permanent therapies for end-stage heart failure. For the moment though they serve largely as bridges to cardiac transplantation, the definitive management of the failing heart. Cardiac transplantation itself is facing a number of challenges that limit its widespread usage globally. This review aims to obtain current perspectives on heart failure treatment, particularly among the three abovementioned modalities, whilst highlighting briefly some of the other novel treatment alternatives emerging globally. A comprehensive review of literature is undertaken from the past few years to understand the recent advancements, knowledge and research trends in this arena. An attempt is also made to understand the factors limiting the employment of modern management principles in the treatment of heart failure in the developing world, with particular emphasis on cardiac donation and transplantation; and the steps that could be taken to improve the desperately low recipient to donor ratio across the globe.
心力衰竭仍然是全球发病和死亡的一个重要原因。存在多种治疗选择,其安全性和可靠性各不相同。干细胞移植和左心室辅助装置植入是近期两项有前景的技术,作为终末期心力衰竭的临时和永久治疗方法,有着光明的未来。不过目前它们主要是作为心脏移植(即衰竭心脏的最终治疗方法)的桥梁。心脏移植本身正面临一些挑战,这些挑战限制了其在全球的广泛应用。本综述旨在获取心力衰竭治疗的当前观点,特别是上述三种治疗方式方面的观点,同时简要强调全球正在出现的一些其他新型治疗选择。对过去几年的文献进行了全面综述,以了解该领域的最新进展、知识和研究趋势。还试图了解限制发展中国家在心力衰竭治疗中采用现代管理原则的因素,特别强调心脏捐赠和移植;以及可以采取哪些措施来改善全球极低的受体与供体比例。