Department of Cardiology, Hospital Santa Cruz, CHLO, Av Prof Reynaldo Santos, 2790-134, Carnaxide, Portugal.
ESC Heart Fail. 2017 Nov;4(4):679-685. doi: 10.1002/ehf2.12210. Epub 2017 Sep 28.
Acute heart failure (HF) is a frequent and life-threatening syndrome with heterogeneous clinical, haemodynamic, and neurohormonal features. This article describes the vascular phenotypes associated with acute decompensated chronic HF (ADCHF), and new-onset acute HF (NOAHF).
Worsening of chronic HF occurs with full activation of adaptive mechanisms that maintain blood pressure (BP) and systemic perfusion. Rapid onset of HF in the setting of previous normal functioning heart not only does not allow full activation of adaptive mechanisms but also generates inappropriate responses from systemic endothelium leading to low BP/hypotension. Consequently, the treatment of ADCHF is based on diuretics and vasodilators, while in NOAHF, vasoconstrictors may be required to maintain BP to allow the correction of the acute cardiac disease.
Patients with ADCHF and NOAHF present different vascular phenotypes with treatment implications.
急性心力衰竭（HF）是一种常见且危及生命的综合征，具有异质性的临床、血流动力学和神经激素特征。本文描述了与急性失代偿性慢性心力衰竭（ADCHF）和新发急性心力衰竭（NOAHF）相关的血管表型。
慢性 HF 的恶化伴随着维持血压（BP）和全身灌注的适应性机制的充分激活。HF 的快速发作在先前正常心脏功能的情况下不仅不允许适应性机制的充分激活，而且还会导致全身内皮系统产生不适当的反应，导致低血压/低血压。因此，ADCHF 的治疗基于利尿剂和血管扩张剂，而在 NOAHF 中，可能需要血管收缩剂来维持血压以允许急性心脏疾病的纠正。
ADCHF 和 NOAHF 患者表现出不同的血管表型，这对治疗有影响。
