Ilieșiu Adriana Mihaela, Hodorogea Andreea Simona, Balahura Ana-Maria, Bădilă Elisabeta
Cardiology and Internal Medicine Department, Theodor Burghele Clinical Hospital, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Internal Medicine Department, Bucharest Clinical Emergency Hospital, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Diagnostics (Basel). 2022 Apr 12;12(4):962. doi: 10.3390/diagnostics12040962.
Worsening chronic heart failure (HF) is responsible for recurrent hospitalization and increased mortality risk after discharge, irrespective to the ejection fraction. Symptoms and signs of pulmonary and systemic congestion are the most common cause for hospitalization of acute decompensated HF, as a consequence of increased cardiac filling pressures. The elevated cardiac filling pressures, also called hemodynamic congestion, may precede the occurrence of clinical congestion by days or weeks. Since HF patients often have comorbidities, dyspnoea, the main symptom of HF, may be also caused by respiratory or other illnesses. Recent studies underline the importance of the diagnosis and treatment of hemodynamic congestion before HF symptoms worsen, reducing hospitalization and improving prognosis. In this paper we review the role of integrated evaluation of biomarkers and imaging technics, i.e., echocardiography and pulmonary ultrasound, for the diagnosis, prognosis and treatment of congestion in HF patients.
慢性心力衰竭（HF）病情恶化是出院后反复住院和死亡风险增加的原因，与射血分数无关。肺和全身充血的症状和体征是急性失代偿性HF住院的最常见原因，这是心脏充盈压升高的结果。升高的心脏充盈压，也称为血流动力学充血，可能在临床充血出现前数天或数周就已出现。由于HF患者常伴有合并症，HF的主要症状呼吸困难也可能由呼吸系统或其他疾病引起。最近的研究强调了在HF症状恶化前诊断和治疗血流动力学充血的重要性，可减少住院并改善预后。在本文中，我们综述了生物标志物与成像技术（即超声心动图和肺部超声）综合评估在HF患者充血诊断、预后及治疗中的作用。
