Cardiology Department, Hospital San Juan de la Cruz, Úbeda, Spain.
Cardiology Department, Hospital Universitario Juan Ramón Jiménez, Huelva, Spain.
Expert Rev Cardiovasc Ther. 2023 Jul-Dec;21(7):473-482. doi: 10.1080/14779072.2023.2215985. Epub 2023 Jun 22.
Worsening heart failure (HF) is associated with a high risk of death and rehospitalization. Despite that, real world evidence about the impact of worsening HF on clinical practice is scarce.
A narrative review about registries addressing recent worsening HF events in Spain, with special emphasis on patients recently hospitalized for HF was performed.
Worsening HF can be defined as situations where the patient's HF deteriorates to the extent that it necessitates initiation or intensification of diuretic treatment (mainly intravenous). The events can occur at the outpatient level, generally in the day hospital, in the emergency department or even hospitalization. Early identification of worsening HF events is essential to establish appropriate treatment as soon as possible. In this context, robust clinical benefits have been reported for renin-angiotensin system inhibitors, sacubitril-valsartan, beta-blockers, mineralocorticoid receptor antagonists, SGLT2 inhibitors, and vericiguat. In Spain, several registries of patients with HF have been developed, some of them including patients recently hospitalized for HF, but not with recent worsening HF events. Therefore, registries addressing recent worsening events would be desirable. Using a practical approach, this review analyzes the importance of worsening HF events, with special emphasis on Spanish data.
心力衰竭（HF）恶化与死亡和再住院风险增加相关。尽管如此，关于 HF 恶化对临床实践影响的真实世界证据仍然很少。
对解决西班牙最近 HF 恶化事件的登记处进行了叙述性综述，特别强调了最近因 HF 住院的患者。
HF 恶化可以定义为患者的 HF 恶化到需要开始或加强利尿剂治疗（主要是静脉内）的程度。这些事件可以在门诊水平、一般在日间医院、急诊科甚至住院期间发生。早期识别 HF 恶化事件对于尽快建立适当的治疗至关重要。在这种情况下，肾素-血管紧张素系统抑制剂、沙库巴曲缬沙坦、β受体阻滞剂、盐皮质激素受体拮抗剂、SGLT2 抑制剂和维立西呱已报告具有显著的临床获益。在西班牙，已经开发了多个 HF 患者登记处，其中一些登记处包括最近因 HF 住院的患者，但不包括最近发生 HF 恶化事件的患者。因此，需要登记最近发生的恶化事件。本文通过一种实用的方法，分析了 HF 恶化事件的重要性，特别强调了西班牙的数据。
