Vaikunth Sumeet, Sundaravel Swethika, Saef Joshua, Ortega-Legaspi Juan
Philadelphia Adult Congenital Heart Center, Penn Medicine & Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA.
Advanced Heart Failure Section, Cardiovascular Medicine Division, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Curr Heart Fail Rep. 2023 Oct;20(5):401-416. doi: 10.1007/s11897-023-00621-1. Epub 2023 Aug 16.
This paper reviews the latest literature on the growing field of heart failure in the adult congenital heart disease population.
After highlighting the increasing prevalence and a few of the unique potential causes, including the concept of early senescence, this review begins with novel medical management strategies such as the angiotensin II receptor blocker and neprilysin inhibitors and sodium glucose cotransporter-2 inhibitors. Then, it addresses the latest applications of percutaneous techniques like implantable hemodynamic monitoring, transcatheter pulmonary and aortic valve replacement, and mitral clips. Cardiac resynchronization therapy and novel lymphatic system imaging and intervention are then described. Finally, the use of mechanical support devices, temporary and durable, is discussed as well as heart and combined heart and liver transplantation. There have been recent exciting advances in the strategies used to manage adult congenital heart disease patients with heart failure. As this population continues to grow, it is likely we will see further rapid evolution in this field.
本文综述了成人先天性心脏病人群中不断发展的心力衰竭领域的最新文献。
在强调了患病率的上升以及一些独特的潜在病因（包括早期衰老的概念）之后，本综述首先介绍了新型药物治疗策略，如血管紧张素II受体阻滞剂、中性肽链内切酶抑制剂和钠-葡萄糖协同转运蛋白2抑制剂。然后，阐述了经皮技术的最新应用，如植入式血流动力学监测、经导管肺动脉瓣和主动脉瓣置换以及二尖瓣夹合术。接着描述了心脏再同步治疗以及新型淋巴系统成像和干预。最后，讨论了临时和永久性机械支持装置的使用以及心脏移植和心脏联合肝脏移植。在用于治疗患有心力衰竭的成人先天性心脏病患者的策略方面，最近取得了令人兴奋的进展。随着这一人群的持续增长，我们很可能会看到该领域进一步的快速发展。
