Almarzooq Zaid, Pareek Manan, Sinnenberg Lauren, Vaduganathan Muthiah, Mehra Mandeep R
Brigham and Women's Hospital Heart and Vascular Center and Harvard Medical School, Boston, Massachusetts, USA.
Department of Cardiology, North Zealand Hospital, Hillerød, Denmark.
Heart Asia. 2019 Mar 8;11(1):e011150. doi: 10.1136/heartasia-2018-011150. eCollection 2019.
The global burden of heart failure has continued to increase dramatically with 26 million people affected and an estimated health expenditure of $31 billion worldwide. Several practice-influencing studies were reported recently, bringing advances along many frontiers in heart failure, particularly heart failure with reduced ejection fraction. In this article, we discuss nine distinct therapeutic areas that were significantly influenced by this scientific progress. These distinct areas include the emergence of sodium-glucose cotransporter-2 inhibitors, broadening the application of angiotensin-neprilysin inhibition, clinical considerations in therapy withdrawal in those patients with heart failure that 'recover' myocardial function, benefits of low-dose direct oral anticoagulants in sinus rhythm, targeted therapy for treating cardiac amyloidosis, usefulness of mitral valve repair in heart failure, the advent of newer left ventricular assist devices for advanced heart failure, the role of ablation in atrial fibrillation in heart failure, and finally the use of wearable defibrillators to address sudden death.
全球心力衰竭负担持续急剧增加，全球有2600万人受其影响，估计卫生支出达310亿美元。最近报道了几项影响临床实践的研究，在心力衰竭的许多领域取得了进展，尤其是射血分数降低的心力衰竭。在本文中，我们讨论了受这一科学进展显著影响的九个不同治疗领域。这些不同领域包括钠-葡萄糖协同转运蛋白2抑制剂的出现、血管紧张素-脑啡肽酶抑制剂应用范围的扩大、心力衰竭“恢复”心肌功能患者治疗撤药的临床考量、低剂量直接口服抗凝剂在窦性心律中的益处、治疗心脏淀粉样变性的靶向治疗、二尖瓣修复在心力衰竭中的作用、用于晚期心力衰竭的新型左心室辅助装置的出现、心力衰竭患者心房颤动消融的作用，以及最后可穿戴除颤器在预防心源性猝死中的应用。
