Almenar Luis, Zunzunegui José Luis, Barón Gonzalo, Carrasco José Ignacio, Gómez-Doblas Juan José, Comín Josep, Barrios Vivencio, Subirana M Teresa, Díaz-Molina Beatriz
Unidad de Insuficiencia Cardiaca y Trasplante, Servicio de Cardiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
Servicio Materno-Infantil, Hospital Gregorio Marañón, Madrid, Spain.
Rev Esp Cardiol (Engl Ed). 2013 Apr;66(4):290-7. doi: 10.1016/j.rec.2012.10.018. Epub 2013 Jan 12.
In the year 2012, 3 scientific sections-heart failure and transplant, congenital heart disease, and clinical cardiology-are presented together in the same article. The most relevant development in the area of heart failure and transplantation is the 2012 publication of the European guidelines for heart failure. These describe new possibilities for some drugs (eplerenone and ivabradine); expand the criteria for resynchronization, ventricular assist, and peritoneal dialysis; and cover possibilities of percutaneous repair of the mitral valve (MitraClip(®)). The survival of children with hypoplastic left heart syndrome in congenital heart diseases has improved significantly. Instructions for percutaneous techniques and devices have been revised and modified for the treatment of atrial septal defects, ostium secundum, and ventricular septal defects. Hybrid procedures for addressing structural congenital heart defects have become more widespread. In the area of clinical cardiology studies have demonstrated that percutaneous prosthesis implantation has lower mortality than surgical implantation. Use of the CHA2DS2-VASc criteria and of new anticoagulants (dabigatran, rivaroxaban and apixaban) is also recommended. In addition, the development of new sequencing techniques has enabled the analysis of multiple genes.
2012年，心力衰竭与移植、先天性心脏病和临床心脏病学这3个科学领域被放在同一篇文章中呈现。心力衰竭与移植领域最相关的进展是2012年欧洲心力衰竭指南的发布。这些指南描述了某些药物（依普利酮和伊伐布雷定）的新应用可能性；扩大了心脏再同步化、心室辅助和腹膜透析的标准；并涵盖了经皮二尖瓣修复（MitraClip®）的可能性。先天性心脏病中左心发育不全综合征患儿的生存率有了显著提高。经皮技术和器械的使用说明已针对房间隔缺损、继发孔型和室间隔缺损的治疗进行了修订和改进。用于解决先天性心脏结构缺陷的杂交手术已变得更加普遍。在临床心脏病学领域，研究表明经皮假体植入的死亡率低于手术植入。还推荐使用CHA2DS2-VASc标准和新型抗凝剂（达比加群、利伐沙班和阿哌沙班）。此外，新测序技术的发展使得对多个基因的分析成为可能。
