Division of Cardiovascular Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Division of Cardiology, Department of Medicine, University of Utah, Salt Lake City, Utah.
J Am Coll Cardiol. 2020 Aug 11;76(6):719-734. doi: 10.1016/j.jacc.2020.05.075.
Reverse left ventricular (LV) remodeling and recovery of LV function are associated with improved clinical outcomes in patients with heart failure with reduced ejection fraction. A growing body of evidence suggests that even among patients who experience a complete normalization of LV ejection fraction, a significant proportion will develop recurrent LV dysfunction accompanied by recurrent heart failure events. This has led to intense interest in understanding how to manage patients with heart failure with recovered ejection fraction (HFrecEF). Because of the lack of a standard definition for HFrecEF, and the paucity of clinical data with respect to the natural history of HFrecEF patients, there are no current guidelines on how these patients should be followed up and managed. Accordingly, this JACC Scientific Expert Panel reviews the biology of reverse LV remodeling and the clinical course of patients with HFrecEF, as well as provides guidelines for defining, diagnosing, and managing patients with HFrecEF.
左心室(LV)逆向重构和 LV 功能的恢复与射血分数降低的心力衰竭患者的临床结局改善相关。越来越多的证据表明,即使在 LV 射血分数完全正常化的患者中,仍有相当一部分会出现复发性 LV 功能障碍伴复发性心力衰竭事件。这导致人们强烈关注如何管理射血分数恢复的心力衰竭(HFrecEF)患者。由于缺乏 HFrecEF 的标准定义,以及 HFrecEF 患者的临床数据有限,目前尚无关于如何对这些患者进行随访和管理的指南。因此,这个 JACC 科学专家小组审查了 LV 逆向重构的生物学以及 HFrecEF 患者的临床过程,并提供了定义、诊断和管理 HFrecEF 患者的指南。