Adhyapak Srilakshmi M, Parachuri V Rao
Department of Cardiology, St. John's Medical College Hospital, Sarjapura Road, Bangalore 560034, India.
Department of Cardiac Surgery, Narayana Hrudayalaya Institute of Medical Sciences, Bangalore, India.
Ther Adv Cardiovasc Dis. 2017 Sep;11(9):231-234. doi: 10.1177/1753944717718719. Epub 2017 Jul 10.
The burden of heart failure has long plagued the productive years of the population, with therapeutic advances in the timely treatment of ischemic heart disease decreasing its associated mortality. Angiotensin-converting enzyme inhibitors and β-blockers have impacted heart failure therapeutics in a revolutionary way. The importance of blockade of the renin-angiotensin system and adrenergic stimulation are fully accepted concepts that apply in young and old, symptomatic and asymptomatic, borderline low and very low Ejection Fraction (EF), left ventricular failure and biventricular failure. Despite several interventions, both pharmaceutical and device based for the treatment of ensuing heart failure, the incidence is increasing in large proportions. Newer molecules like sacubitril show more promise. Despite these novel therapies, several patients relentlessly progress to a stage of advanced heart failure. The use of left-ventricular-assist devices has variable clinical benefit, with some patients progressing to heart transplantation.
心力衰竭的负担长期以来一直困扰着人们的黄金工作年龄段，随着缺血性心脏病及时治疗方面的治疗进展，其相关死亡率有所下降。血管紧张素转换酶抑制剂和β受体阻滞剂以革命性的方式影响了心力衰竭的治疗。阻断肾素-血管紧张素系统和肾上腺素能刺激的重要性是已被充分接受的概念，适用于年轻人和老年人、有症状和无症状者、射血分数（EF）临界低和极低者、左心室衰竭和双心室衰竭。尽管有多种基于药物和设备的干预措施来治疗随之而来的心力衰竭，但发病率仍在大幅上升。诸如沙库巴曲之类的新型分子显示出更大的前景。尽管有这些新型疗法，仍有若干患者无情地进展到晚期心力衰竭阶段。左心室辅助装置的使用具有不同的临床益处，一些患者会进展到心脏移植阶段。
