Becher Peter Moritz, Seiffert Moritz
Klinik für Kardiologie, Universitäres Herz- und Gefäßzentrum, Universitätsklinikum Hamburg-Eppendorf, 20246, Hamburg, Deutschland.
Standort Hamburg/Kiel/Lübeck, Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Hamburg, Deutschland.
Herz. 2023 Mar;48(2):101-108. doi: 10.1007/s00059-022-05160-4. Epub 2023 Jan 26.
The pharmacotherapy of heart failure has evolved in recent years and with the aid of new classes of drugs symptomatic and prognostic improvements can be achieved in patients with heart failure. Heart failure is particularly frequently associated with coronary artery disease or higher grade, often functional valve defects. In the context of the underlying disease, the operative risk is often increased, so that interventional treatment is preferred over surgical treatment options in interdisciplinary heart teams. Promising approaches with very different challenges are emerging for interventional myocardial revascularization and percutaneous correction of high-grade aortic valve stenosis or functional mitral or tricuspid valve regurgitation. It has consistently been shown that an elaborate diagnostic work-up and differentiated patient selection are decisive to achieve a prognostic or symptomatic benefit in these patients using interventional treatment. While awaiting further study data on this topic, the integration of a multidisciplinary heart team is essential to ensure a complementary and balanced therapeutic approach for patient-centered care in this complex patient population.
近年来,心力衰竭的药物治疗取得了进展,借助新型药物,心力衰竭患者的症状和预后可得到改善。心力衰竭尤其常与冠状动脉疾病或更严重的、通常为功能性的瓣膜缺陷相关。在基础疾病的背景下,手术风险往往会增加,因此在跨学科心脏团队中,介入治疗比手术治疗更受青睐。介入性心肌血运重建以及经皮纠正严重主动脉瓣狭窄或功能性二尖瓣或三尖瓣反流等具有不同挑战的有前景的方法正在出现。一直以来的研究表明,精心的诊断评估和差异化的患者选择对于这些患者采用介入治疗实现预后或症状改善至关重要。在等待关于该主题的进一步研究数据时,组建多学科心脏团队对于确保在这一复杂患者群体中以患者为中心的护理采用互补且平衡的治疗方法至关重要。