Cardiology and Cardiac Catheterization Laboratory, ASST Spedali Civili di Brescia, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
AP-HP Department of Anesthesia and Critical Care, Hôpital Lariboisière, Université Paris Cité, Inserm MASCOT, Paris, France.
Eur J Heart Fail. 2023 Jul;25(7):1115-1131. doi: 10.1002/ejhf.2888. Epub 2023 Jul 13.
Acute heart failure is a major cause of urgent hospitalizations. These are followed by marked increases in death and rehospitalization rates, which then decline exponentially though they remain higher than in patients without a recent hospitalization. Therefore, optimal management of patients with acute heart failure before discharge and in the early post-discharge phase is critical. First, it may prevent rehospitalizations through the early detection and effective treatment of residual or recurrent congestion, the main manifestation of decompensation. Second, initiation at pre-discharge and titration to target doses in the early post-discharge period, of guideline-directed medical therapy may improve both short- and long-term outcomes. Third, in chronic heart failure, medical treatment is often left unchanged, so the acute heart failure hospitalization presents an opportunity for implementation of therapy. The aim of this scientific statement by the Heart Failure Association of the European Society of Cardiology is to summarize recent findings that have implications for clinical management both in the pre-discharge and the early post-discharge phase after a hospitalization for acute heart failure.
急性心力衰竭是紧急住院的主要原因。随之而来的是死亡率和再住院率的显著增加，尽管这些比率呈指数下降，但仍高于近期未住院的患者。因此，在出院前和出院后早期阶段对急性心力衰竭患者进行最佳管理至关重要。首先，通过早期发现和有效治疗残留或复发的充血（失代偿的主要表现），可以预防再住院。其次，在出院前开始并在出院后早期阶段滴定至目标剂量的指南导向的药物治疗，可能会改善短期和长期结局。第三，在慢性心力衰竭中，药物治疗通常保持不变，因此急性心力衰竭住院为实施治疗提供了机会。欧洲心脏病学会心力衰竭协会的这份科学声明旨在总结最近的发现，这些发现对急性心力衰竭住院患者在出院前和出院后早期阶段的临床管理具有重要意义。
