Zhu Ruiqi, Hu Yu, Tang Liang
Department of Hematology, Wuhan Union Hospital of Huazhong University of Science and Technology, Wuhan, 430030 China.
Thromb J. 2017 Apr 24;15:12. doi: 10.1186/s12959-017-0135-3. eCollection 2017.
Patients with reduced cardiac function are thought to have a higher risk of venous thromboembolism (VTE). Additionally, they are vulnerable to complications of pulmonary embolism (PE) as well as right heart failure (HF), which in return is supposed to increase the rate of mortality. Studies focusing on VTE in heart failure patients were rare in Asian countries before the 21st century. Nowadays, more and more data are becoming available in this field in Asia. It is already known that heart failure can increase the risk of VTE, but so far a consensus on this issue has not been reached for many years, not only in Asian countries but all over the world. This condition may be due to the detailed pathological advancement in Virchow's triad and some other theories. In clinical practice, VTE, especially PE is difficult to diagnose in patients with heart failure because of overlapping symptoms (e.g. cough and chest pain) and the elevation of laboratory markers (e.g. probrain natriuretic peptide (NT-proBNP) and D-dimer in both heart failure and VTE patients). Management of VTE in heart failure patients is also controversial because heart failure patients always have complications, such as renal failure and hepatic failure, which increase the risk of bleeding. In this study, we analyzed data from China, Japan, Korea, Singapore and India mainly to get a better understanding of the research progress in VTE in patients with heart failure. The aim of this review is to discuss the risk, incidence, advancement of diagnosis, management and prevention of VTE in patients with heart failure in Asian countries.
心脏功能减退的患者被认为发生静脉血栓栓塞（VTE）的风险更高。此外，他们易发生肺栓塞（PE）以及右心衰竭（HF）并发症，而这反过来又会增加死亡率。在21世纪之前，亚洲国家针对心力衰竭患者VTE的研究很少。如今，亚洲在这一领域有越来越多的数据。已知心力衰竭会增加VTE风险，但多年来，不仅在亚洲国家，在全世界范围内，关于这个问题都尚未达成共识。这种情况可能归因于维勒布兰德氏三联征的详细病理进展及其他一些理论。在临床实践中，由于症状重叠（如咳嗽和胸痛）以及实验室指标升高（如心力衰竭患者和VTE患者的脑钠肽前体（NT-proBNP）和D-二聚体），心力衰竭患者的VTE，尤其是PE很难诊断。心力衰竭患者VTE的管理也存在争议，因为心力衰竭患者常伴有并发症，如肾衰竭和肝衰竭，这会增加出血风险。在本研究中，我们分析了来自中国、日本、韩国、新加坡和印度的数据，主要是为了更好地了解心力衰竭患者VTE的研究进展。这篇综述的目的是讨论亚洲国家心力衰竭患者VTE的风险、发病率、诊断进展、管理及预防。
