Parch Jonathan, Powell Chloe
Jonathan Parch practices cardiothoracic surgery at the Smidt Heart Institute at Cedars-Sinai Medical Center in Los Angeles, Calif. Chloe Powell is a clinical instructor of family medicine in the Primary Care Physician Assistant Program at the University of Southern California's Keck School of Medicine in Alhambra, Calif. The authors have disclosed no potential conflicts of interest, financial or otherwise.
JAAPA. 2019 Jan;32(1):11-15. doi: 10.1097/01.JAA.0000550282.19722.93.
Heart failure is a leading cause of hospital admissions and death in the United States and worldwide. In 2016, the American Heart Association, the American College of Cardiology, and the Heart Failure Society of America released a joint focused guideline update for the management of patients with Stage C heart failure with reduced ejection fraction. An additional update released in 2017 reinforces the 2016 update's strong recommendation for substituting angiotensin-converting enzyme inhibitors or angiotensin receptor blockers with an angiotensin receptor-neprilysin inhibitor to reduce morbidity and mortality in selected patients. The 2017 and 2016 updates also support adding a sinoatrial node modulator to further reduce heart rates in patients already maximized on beta-blocker therapy. These innovative therapies can significantly improve patients' quality of life and reduce the healthcare costs associated with managing heart failure.
心力衰竭是美国乃至全球住院和死亡的主要原因。2016年，美国心脏协会、美国心脏病学会和美国心力衰竭学会联合发布了一份重点指南更新，用于指导射血分数降低的C期心力衰竭患者的管理。2017年发布的另一项更新强化了2016年更新中的强烈建议，即用血管紧张素受体脑啡肽酶抑制剂替代血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂，以降低特定患者的发病率和死亡率。2017年和2016年的更新还支持添加窦房结调节剂，以进一步降低已接受最大剂量β受体阻滞剂治疗患者的心率。这些创新疗法可显著改善患者的生活质量，并降低与心力衰竭管理相关的医疗成本。
