Kempf T, Bavendiek U, Bauersachs J
Klinik für Kardiologie und Angiologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.
Internist (Berl). 2017 Sep;58(9):990-999. doi: 10.1007/s00108-017-0277-1.
Heart failure is a disease with a high prevalence and incidence. New therapeutic approaches are needed to prevent the onset of heart failure and to reduce the high morbidity and mortality associated with this disease. An optimized therapy of arterial hypertension in patients with risk factors and the use of the SGLT2 inhibitor empagliflozin in type 2 diabetics are proven strategies to prevent heart failure. The therapeutic options in heart failure with preserved ejection fraction are still insufficient. In heart failure with reduced ejection fraction sacubitril/valsartan, the first approved angiotensin receptor-neprilysin inhibitor, is superior to an angiotensin converting enzyme (ACE) inhibitor. Whether digitalis affects the prognosis in heart failure remains unclear; however, serum concentration should be targeted at the lower therapeutic range. Iron supplementation in heart failure with reduced systolic function and iron deficiency improves symptoms and quality of life.
心力衰竭是一种患病率和发病率都很高的疾病。需要新的治疗方法来预防心力衰竭的发生，并降低与该疾病相关的高发病率和死亡率。对有危险因素的患者进行优化的动脉高血压治疗以及在2型糖尿病患者中使用钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂恩格列净是预防心力衰竭的已证实策略。射血分数保留的心力衰竭的治疗选择仍然不足。在射血分数降低的心力衰竭中，首个获批的血管紧张素受体脑啡肽酶抑制剂沙库巴曲缬沙坦优于血管紧张素转换酶（ACE）抑制剂。洋地黄是否影响心力衰竭的预后仍不清楚；然而，血清浓度应靶向较低的治疗范围。对收缩功能降低且缺铁的心力衰竭患者补充铁剂可改善症状和生活质量。
