Scarà Antonio, Palamà Zefferino, Robles Antonio Gianluca, Dei Lorenzo-Lupo, Borrelli Alessio, Zanin Federico, Pignalosa Leonardo, Romano Silvio, Sciarra Luigi
San Carlo di Nancy Hospital-GVM, 00165 Roma, Italy.
Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
J Cardiovasc Dev Dis. 2024 Apr 17;11(4):122. doi: 10.3390/jcdd11040122.
Heart failure (HF) represents a significant global health challenge that is still responsible for increasing morbidity and mortality despite advancements in pharmacological treatments. This review investigates the effectiveness of non-pharmacological interventions in the management of HF, examining lifestyle measures, physical activity, and the role of some electrical therapies such as catheter ablation, cardiac resynchronization therapy (CRT), and cardiac contractility modulation (CCM). Structured exercise training is a cornerstone in this field, demonstrating terrific improvements in functional status, quality of life, and mortality risk reduction, particularly in patients with HF with reduced ejection fraction (HFrEF). Catheter ablation for atrial fibrillation, premature ventricular beats, and ventricular tachycardia aids in improving left ventricular function by reducing arrhythmic burden. CRT remains a key intervention for selected HF patients, helping achieve left ventricular reverse remodeling and improving symptoms. Additionally, the emerging therapy of CCM provides a novel opportunity for patients who do not meet CRT criteria or are non-responders. Integrating non-pharmacological interventions such as digital health alongside specific medications is key for optimizing outcomes in HF management. It is imperative to tailor approaches to individual patients in this diverse patient population to maximize benefits. Further research is warranted to improve treatment strategies and enhance patient outcomes in HF management.
心力衰竭（HF）是一项重大的全球健康挑战，尽管药物治疗取得了进展，但它仍然导致发病率和死亡率不断上升。本综述探讨了非药物干预在HF管理中的有效性，研究了生活方式措施、体育活动以及一些电疗法（如导管消融、心脏再同步治疗（CRT）和心脏收缩力调制（CCM））的作用。结构化运动训练是该领域的基石，在功能状态、生活质量和降低死亡风险方面显示出显著改善，尤其是在射血分数降低的心力衰竭（HFrEF）患者中。针对心房颤动、室性早搏和室性心动过速的导管消融通过减轻心律失常负担有助于改善左心室功能。CRT仍然是选定HF患者的关键干预措施，有助于实现左心室逆向重构并改善症状。此外，新兴的CCM疗法为不符合CRT标准或无反应的患者提供了新的机会。将数字健康等非药物干预与特定药物相结合是优化HF管理结果的关键。在这个多样化的患者群体中，根据个体患者量身定制方法以最大化益处至关重要。有必要进行进一步研究以改善治疗策略并提高HF管理中的患者结局。
