Hicks Albert, Velazco Jorge F, Gohar Salman, Seliem Ahmed, Hall Shelley A, Michel Jeffrey B
Division of Cardiology, Baylor Scott and White Medical Center - TempleTempleTexas.
Division of Pulmonary and Critical Care Medicine, Baylor Scott and White Medical Center - TempleTempleTexas.
Proc (Bayl Univ Med Cent). 2020 Jun 2;33(3):350-356. doi: 10.1080/08998280.2020.1765663. eCollection 2020 Jul.
Patients suffering advanced heart failure with reduced ejection fraction (HFrEF) account for a large portion of patients admitted to hospitals worldwide. Mortality and 30-day readmission rates for HFrEF are now a focus of value-based payment models, making management of this disease a priority for hospitals, physicians, and payers alike. Angiotensin-converting enzyme inhibitors have been the cornerstone of therapy for decades. However, with treatment, the prognosis for patients with advanced HFrEF remains poor. Fortunately, advances in medical therapy and mechanical support offer some patients improvement in both survival and quality of life. We review advances in short- and long-term mechanical support and explore changes to organ allocation for cardiac transplantation. In addition, we provide a guide to facilitate appropriate referral to an advanced heart failure team.
射血分数降低的晚期心力衰竭（HFrEF）患者占全球住院患者的很大一部分。HFrEF的死亡率和30天再入院率现在是基于价值的支付模式的重点，这使得这种疾病的管理成为医院、医生和支付方的优先事项。几十年来，血管紧张素转换酶抑制剂一直是治疗的基石。然而，尽管进行了治疗，晚期HFrEF患者的预后仍然很差。幸运的是，药物治疗和机械支持的进展为一些患者带来了生存和生活质量的改善。我们回顾了短期和长期机械支持的进展，并探讨了心脏移植器官分配的变化。此外，我们提供了一份指南，以促进适当地转诊至晚期心力衰竭治疗团队。
