Ladouceur Magalie, Valdeolmillos Estibaliz, Karsenty Clément, Hascoet Sébastien, Moceri Pamela, Le Gloan Laurianne
Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, 75015 Paris, France.
Centre de Recherche Cardiovasculaire de Paris, INSERM U970, Université de Paris Cité, 75015 Paris, France.
J Cardiovasc Dev Dis. 2023 Apr 24;10(5):190. doi: 10.3390/jcdd10050190.
Adult congenital heart disease (ACHD) is a growing population that requires life-long care due to advances in pediatric care and surgical or catheter procedures. Despite this, drug therapy in ACHD remains largely empiric due to the lack of clinical data, and formalized guidelines on drug therapy are currently lacking. The aging ACHD population has led to an increase in late cardiovascular complications such as heart failure, arrhythmias, and pulmonary hypertension. Pharmacotherapy, with few exceptions, in ACHD is largely supportive, whereas significant structural abnormalities usually require interventional, surgical, or percutaneous treatment. Recent advances in ACHD have prolonged survival for these patients, but further research is needed to determine the most effective treatment options for these patients. A better understanding of the use of cardiac drugs in ACHD patients could lead to improved treatment outcomes and a better quality of life for these patients. This review aims to provide an overview of the current status of cardiac drugs in ACHD cardiovascular medicine, including the rationale, limited current evidence, and knowledge gaps in this growing area.
成人先天性心脏病(ACHD)患者群体不断壮大,这得益于儿科护理以及外科手术或导管介入治疗技术的进步,这类患者需要终身护理。尽管如此,由于缺乏临床数据,ACHD的药物治疗在很大程度上仍基于经验,目前也缺乏药物治疗的规范指南。ACHD患者群体的老龄化导致心力衰竭、心律失常和肺动脉高压等晚期心血管并发症增多。除少数例外情况,ACHD的药物治疗大多起支持作用,而明显的结构异常通常需要介入、外科或经皮治疗。ACHD领域的最新进展延长了这些患者的生存期,但仍需进一步研究以确定针对这些患者最有效的治疗方案。更好地了解ACHD患者心脏药物的使用情况,可能会改善这些患者的治疗效果并提高其生活质量。本综述旨在概述ACHD心血管医学中心脏药物的现状,包括用药原理、目前有限的证据以及这个不断发展领域中的知识空白。