de la Espriella Rafael, Cobo Marta, Santas Enrique, Verbrugge Frederik H, Fudim Marat, Girerd Nicolas, Miñana Gema, Górriz José Luis, Bayés-Genís Antoni, Núñez Julio
Servicio de Cardiología, Hospital Clínico Universitario de Valencia, INCLIVA, Valencia, Spain.
Servicio de Cardiología, Hospital Puerta de Hierro, Majadahonda, Madrid, Spain.
Rev Esp Cardiol (Engl Ed). 2023 Jan;76(1):47-57. doi: 10.1016/j.rec.2022.07.009. Epub 2022 Aug 4.
Congestion plays a major role in the pathogenesis, presentation, and prognosis of heart failure and is an important therapeutic target. However, its severity and organ and compartment distribution vary widely among patients, illustrating the complexity of this phenomenon. Although clinical symptoms and signs are useful to assess congestion and manage volume status in individual patients, they have limited sensitivity and do not allow identification of congestion phenotype. This leads to diagnostic uncertainty and hampers therapeutic decision-making. The present article provides an updated overview of circulating biomarkers, imaging modalities (ie, cardiac and extracardiac ultrasound), and invasive techniques that might help clinicians to identify different congestion profiles and guide the management strategy in this diverse population of high-risk patients with heart failure.
充血在心力衰竭的发病机制、临床表现和预后中起主要作用，是一个重要的治疗靶点。然而，其严重程度以及在器官和腔室中的分布在患者之间差异很大，这说明了这种现象的复杂性。尽管临床症状和体征有助于评估个体患者的充血情况并管理容量状态，但它们的敏感性有限，无法识别充血表型。这导致诊断不确定性，并妨碍治疗决策。本文提供了关于循环生物标志物、成像方式（即心脏和心脏外超声）以及侵入性技术的最新综述，这些可能有助于临床医生识别不同的充血特征，并指导对这类多样化的高危心力衰竭患者群体的管理策略。
