Department of Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, Yale University School of Medicine, New Haven, CT, USA.
Department of Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, Yale University School of Medicine, New Haven, CT, USA.
Heart Fail Clin. 2018 Jul;14(3):413-423. doi: 10.1016/j.hfc.2018.03.007.
Right heart failure is caused by right heart dysfunction resulting in suboptimal stroke volume to supply the pulmonary circulation. Therapeutic developments mean that patients with acute right heart failure survive to hospital discharge and live with chronic right heart failure. Chronic right heart failure management aims to reduce afterload, optimize preload, and support contractility, with the best evidence available in vascular targeted therapy for pulmonary arterial hypertension. However, the management of chronic right heart failure relies on adapting therapies for left ventricular heart failure to the right. We review right heart failure management in the ambulatory setting and its challenges.
右心衰竭是由右心功能障碍引起的,导致每搏输出量不足以满足肺循环的需要。治疗方法的发展意味着患有急性右心衰竭的患者能够存活到出院,并患有慢性右心衰竭。慢性右心衰竭的管理旨在降低后负荷、优化前负荷和支持收缩力,目前在肺动脉高压的血管靶向治疗中已有最佳证据。然而,慢性右心衰竭的管理依赖于将治疗左心室心力衰竭的疗法适应于右心。我们回顾了门诊环境中右心衰竭的管理及其挑战。