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2022 ACC/AHA 血管疾病诊断与管理指南:美国心脏协会/美国心脏病学会联合临床实践指南委员会的报告。

2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines.

出版信息

J Am Coll Cardiol. 2022 Dec 13;80(24):e223-e393. doi: 10.1016/j.jacc.2022.08.004. Epub 2022 Nov 2.

Abstract

AIM

The "2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease" provides recommendations to guide clinicians in the diagnosis, genetic evaluation and family screening, medical therapy, endovascular and surgical treatment, and long-term surveillance of patients with aortic disease across its multiple clinical presentation subsets (ie, asymptomatic, stable symptomatic, and acute aortic syndromes).

METHODS

A comprehensive literature search was conducted from January 2021 to April 2021, encompassing studies, reviews, and other evidence conducted on human subjects that were published in English from PubMed, EMBASE, the Cochrane Library, CINHL Complete, and other selected databases relevant to this guideline. Additional relevant studies, published through June 2022 during the guideline writing process, were also considered by the writing committee, where appropriate.

STRUCTURE

Recommendations from previously published AHA/ACC guidelines on thoracic aortic disease, peripheral artery disease, and bicuspid aortic valve disease have been updated with new evidence to guide clinicians. In addition, new recommendations addressing comprehensive care for patients with aortic disease have been developed. There is added emphasis on the role of shared decision making, especially in the management of patients with aortic disease both before and during pregnancy. The is also an increased emphasis on the importance of institutional interventional volume and multidisciplinary aortic team expertise in the care of patients with aortic disease.

摘要

目的

“2022ACC/AHA 主动脉疾病诊断与管理指南”提供了一系列建议,旨在为临床医生提供指导,以帮助他们对患有各种临床表现(即无症状、稳定型有症状和急性主动脉综合征)的主动脉疾病患者进行诊断、遗传评估和家族筛查、药物治疗、腔内和手术治疗以及长期监测。

方法

我们于 2021 年 1 月至 2021 年 4 月进行了全面的文献检索,检索范围涵盖了从 PubMed、EMBASE、Cochrane 图书馆、CINHL Complete 及其他与本指南相关的选定数据库中收录的以人类为研究对象的相关研究、综述和其他证据。指南撰写过程中,写作委员会还酌情考虑了 2022 年 6 月之前发表的与本指南相关的其他新的相关研究。

结构

本指南对先前发表的关于胸主动脉疾病、外周动脉疾病和二叶式主动脉瓣疾病的 AHA/ACC 指南中的建议进行了更新,纳入了新的证据以指导临床医生。此外,本指南还制定了新的建议,旨在为主动脉疾病患者提供全面的护理。特别强调了在主动脉疾病患者妊娠前后的管理中进行共同决策的作用。本指南还更加重视机构介入量和多学科主动脉团队专业知识在主动脉疾病患者治疗中的重要性。

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