联合新型心衰药物治疗射血分数降低心衰：从临床试验到临床实践。

Combining New Classes of Drugs for HFrEF: from Trials to Clinical Practice.

机构信息

Centre for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI), University of Trieste, Italy.

出版信息

Eur J Intern Med. 2021 Aug;90:10-15. doi: 10.1016/j.ejim.2021.05.017. Epub 2021 Jun 3.

DOI:10.1016/j.ejim.2021.05.017

PMID:34090751

Abstract

Pharmacological approach to heart failure with reduced ejection fraction (HFrEF) is evolving, as recently published large randomized clinical trials have implemented the disposal of HFrEF treatments with four new classes of drugs, namely angiotensin receptor/neprilysin inhibitor , sodium-glucose co-transporters 2 inhibitors , soluble guanylate cyclase modulators and myosin activators, which have proved to further improve patients' quality of life and long-term outcomes. As these novel drugs target additional pathways not already intercepted by the guideline-directed medical therapy, integration of them in the management of HFrEF is desirable. This review paper aims to provide an overview of the current evolving concepts of HFrEF therapy joining the most recent evidences and to furnish practical suggestions for the use of these new classes of drugs in clinical practice.

摘要

心力衰竭伴射血分数降低（HFrEF）的药物治疗方法正在不断发展，因为最近发表的大型随机临床试验已经淘汰了 HFrEF 的四种新类别的治疗方法，即血管紧张素受体/脑啡肽酶抑制剂、钠-葡萄糖共转运蛋白 2 抑制剂、可溶性鸟苷酸环化酶调节剂和肌球蛋白激活剂，这些药物已被证明可以进一步提高患者的生活质量和长期预后。由于这些新型药物针对的是指南指导的药物治疗尚未干预的其他途径，因此将它们整合到 HFrEF 的管理中是可取的。本文旨在概述 HFrEF 治疗的最新进展，并提供这些新药在临床实践中应用的实用建议。