Parthenakis Fragkiskos, Maragkoudakis Spyridon, Marketou Maria, Patrianakos Alexandros, Zacharis Evaggelos, Vardas Panos
Cardiology Department, Heraklion University Hospital, Greece.
Cardiology Department, Heraklion University Hospital, Greece.
Hellenic J Cardiol. 2016 Sep-Oct;57(5):311-314. doi: 10.1016/j.hjc.2016.11.027. Epub 2016 Nov 22.
Current national and international guidelines, including those of the European Society of Cardiology, recognize that the assessment of prognosis should be a part of the standard management for patients with chronic heart failure (CHF). However, these same guidelines recognize the inherent difficulty of this process. A variety of factors contribute to this difficulty, including the varying etiology, frequent co-morbidity and, perhaps most importantly, huge inter-individual variability in the disease progression and outcome. Although CHF is chronic, it is also a condition in which significant proportions of patients experience apparently 'sudden' death, which almost certainly contributes to our difficulty in assessing individual patient prognosis. A useful tool for the risk stratification of heart failure patients is dobutamine stress echocardiography (DSE), which determines the myocardial viability in ischemic cardiomyopathy and myocardial contractile reserve in idiopathic cardiomyopathy.
当前的国内和国际指南，包括欧洲心脏病学会的指南，都认识到预后评估应成为慢性心力衰竭（CHF）患者标准管理的一部分。然而，这些指南也认识到这一过程存在内在困难。多种因素导致了这一困难，包括病因各异、频繁合并症，或许最重要的是，疾病进展和结局存在巨大的个体差异。尽管CHF是一种慢性疾病，但仍有相当比例的患者会出现明显的“猝死”，这几乎肯定增加了我们评估个体患者预后的难度。多巴酚丁胺负荷超声心动图（DSE）是心力衰竭患者风险分层的一种有用工具，它可确定缺血性心肌病中的心肌存活性以及特发性心肌病中的心肌收缩储备。
