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心力衰竭的一年:临床和临床前研究进展。

A year in heart failure: updates of clinical and preclinical findings.

机构信息

Translational Cardiology, Center for Molecular Medicine, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.

Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden.

出版信息

ESC Heart Fail. 2023 Aug;10(4):2150-2158. doi: 10.1002/ehf2.14377. Epub 2023 Apr 18.

Abstract

We witnessed major advances in the management of heart failure (HF) in 2022. Results of recent clinical and preclinical investigations aid preventive strategies, diagnostic efforts, and therapeutic interventions, and collectively, they hold promises for a more effective HF care for the near future. Accordingly, currently available information extends the 2021 European Society of Cardiology guidelines and provides a solid background for the introduction of improved clinical approaches in the number of HF-related cases. Elaboration on the relationships between epidemiological data and risk factors lead to better understanding of the pathophysiology of HF with reduced ejection fraction and HF with preserved ejection fraction. The clinical consequences of valvular dysfunctions are increasingly interpreted not only in their haemodynamic consequences but also in association with their pathogenetic factors and modern corrective treatment possibilities. The influence of coronavirus disease 2019 pandemic on the clinical care of HF appeared to be less intense in 2022 than before; hence, this period allowed to refine coronavirus disease 2019 management options for HF patients. Moreover, cardio-oncology emerges as a new subdiscipline providing significant improvements in clinical outcomes for oncology patients. Furthermore, the introduction of state-of-the-art molecular biologic methods, multi-omic approaches forecast improved phenotyping and precision medicine for HF. All above aspects are addressed in this article that highlights a selection of papers published in ESC Heart Failure in 2022.

摘要

2022 年,心力衰竭(HF)的管理取得了重大进展。最近的临床和临床前研究结果为预防策略、诊断工作和治疗干预提供了帮助,它们共同为不久的将来更有效的 HF 治疗提供了希望。因此,目前的信息扩展了 2021 年欧洲心脏病学会指南,并为在大量 HF 相关病例中引入改进的临床方法提供了坚实的基础。对流行病学数据和危险因素之间关系的阐述,导致对射血分数降低和射血分数保留 HF 的病理生理学有了更好的理解。瓣膜功能障碍的临床后果不仅越来越多地从血流动力学后果方面来解释,而且还与它们的发病因素和现代矫正治疗的可能性相关联。2022 年,新冠病毒病 2019 大流行对 HF 临床治疗的影响似乎不如以前强烈;因此,这一时期使 HF 患者的新冠病毒病 2019 管理方案得到了完善。此外,心血管肿瘤学作为一个新的亚专业领域出现,为肿瘤患者的临床结果提供了显著改善。此外,引入最先进的分子生物学方法、多组学方法有望改善 HF 的表型和精准医疗。本文重点介绍了 2022 年发表在 ESC 心力衰竭杂志上的部分论文,探讨了上述所有方面。

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本文引用的文献

2
A validated score to predict one-year and long-term mortality in patients with significant tricuspid regurgitation.
Eur Heart J Open. 2022 Oct 14;2(6):oeac067. doi: 10.1093/ehjopen/oeac067. eCollection 2022 Nov.
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Metabolomics implicate eicosanoids in severe functional mitral regurgitation.
ESC Heart Fail. 2023 Feb;10(1):311-321. doi: 10.1002/ehf2.14160. Epub 2022 Oct 10.
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Systemic blood pressure in severe aortic stenosis: Haemodynamic correlates and long-term prognostic impact.
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Systematic review and meta-analysis of intravenous iron-carbohydrate complexes in HFrEF patients with iron deficiency.
ESC Heart Fail. 2023 Feb;10(1):44-56. doi: 10.1002/ehf2.14177. Epub 2022 Sep 30.
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Aetiology of chronic heart failure in patients from a super-aged society: the KUNIUMI registry chronic cohort.
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