Universidad Anáhuac México, Huixquilucan, Estado de México, Mexico.
Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada.
Prog Cardiovasc Dis. 2024 Jan-Feb;82:43-54. doi: 10.1016/j.pcad.2024.01.004. Epub 2024 Jan 11.
The field of heart failure has evolved in terms of the therapies that are available including pharmaceutical and device therapies. There is now substantial randomized trial data to indicate that dietary sodium restriction does not provide the reduction in clinical events with accepted heterogeneity in the clinical trial results. Dietary sodium restriction should be considered for some but not all patients and with different objectives than clinical outcomes but instead for potential quality of life benefit. In addition, fluid restriction, once the mainstay of clinical practice, has not shown to be of any additional benefit for patients in hospital or in the ambulatory care setting and therefore should be considered to be used cautiously (if at all) in clinical practice. Further developments and clinical trials are needed in this area to better identify patients who may benefit or have harm from these lower cost interventions and future research should focus on large scale, high quality, clinical trials rather than observational data to drive clinical practice.
心力衰竭领域在治疗方法方面已经发展，包括药物和器械治疗。现在有大量的随机临床试验数据表明，饮食钠限制并不能降低临床事件，临床试验结果存在显著的异质性。饮食钠限制应该考虑用于某些但不是所有患者，并且与临床结果的不同目标，而是为了潜在的生活质量获益。此外，曾经是临床实践主要方法的液体限制，并未显示对住院或门诊患者有任何额外益处，因此在临床实践中应谨慎考虑（如果使用的话）。在这一领域需要进一步的发展和临床试验，以更好地确定可能从这些低成本干预中获益或受到伤害的患者，未来的研究应该侧重于大规模、高质量的临床试验，而不是观察性数据，以推动临床实践。
