Farmakis Dimitrios, Parissis John, Lekakis John, Filippatos Gerasimos
Heart Failure Unit, Department of Cardiology, Attikon University Hospital, Athens, Greece.
Heart Failure Unit, Department of Cardiology, Attikon University Hospital, Athens, Greece.
Rev Esp Cardiol (Engl Ed). 2015 Mar;68(3):245-8. doi: 10.1016/j.rec.2014.11.004. Epub 2015 Feb 4.
Acute heart failure represents the first cause of hospitalization in elderly persons and is the main determinant of the huge healthcare expenditure related to heart failure. Despite therapeutic advances, the prognosis of acute heart failure is poor, with in-hospital mortality ranging from 4% to 7%, 60- to 90-day mortality ranging from 7% to 11%, and 60- to 90-day rehospitalization from 25% to 30%. Several factors including cardiovascular and noncardiovascular conditions as well as patient-related and iatrogenic factors may precipitate the rapid development or deterioration of signs and symptoms of heart failure, thus leading to an acute heart failure episode that usually requires patient hospitalization. The primary prevention of acute heart failure mainly concerns the prevention, early diagnosis, and treatment of cardiovascular risk factors and heart disease, including coronary artery disease, while the secondary prevention of a new episode of decompensation requires the optimization of heart failure therapy, patient education, and the development of an effective transition and follow-up plan.
急性心力衰竭是老年人住院的首要原因，也是导致心力衰竭相关巨额医疗费用的主要因素。尽管治疗取得了进展，但急性心力衰竭的预后较差，住院死亡率为4%至7%，60至90天死亡率为7%至11%，60至90天再住院率为25%至30%。包括心血管和非心血管疾病以及患者相关和医源性因素在内的多种因素，可能促使心力衰竭体征和症状迅速发展或恶化，从而导致急性心力衰竭发作，通常需要患者住院治疗。急性心力衰竭的一级预防主要涉及心血管危险因素和心脏病（包括冠状动脉疾病）的预防、早期诊断和治疗，而失代偿新发作的二级预防则需要优化心力衰竭治疗、患者教育以及制定有效的过渡和随访计划。
