Center for Structural Heart Disease, Henry Ford Hospital, Detroit, USA.
Center for Structural Heart Disease, Henry Ford Hospital, Detroit, USA.
Curr Probl Cardiol. 2024 Aug;49(8):102646. doi: 10.1016/j.cpcardiol.2024.102646. Epub 2024 May 30.
Up to 20 % of patients presenting with acute heart failure and cardiogenic shock have a structural etiology. Despite efforts in timely management, mortality rates remain alarmingly high, ranging from 50 % to 80 %. Surgical intervention is often the definitive treatment for structural heart disease; however, many patients are considered high risk or unsuitable candidates for such procedures. Consequently, there has been a paradigm shift towards the development of novel percutaneous management strategies and temporizing interventions. This article aims to provide a comprehensive review of the pathophysiology of valvular and structural heart conditions presenting in cardiogenic shock, focusing on the evolving landscape of mechanical circulatory support devices and other management modalities.
高达 20%的急性心力衰竭和心源性休克患者存在结构性病因。尽管在及时管理方面做出了努力,但死亡率仍然高得惊人,范围在 50%至 80%之间。手术干预通常是结构性心脏病的明确治疗方法;然而,许多患者被认为存在高风险或不适合此类手术。因此,人们的观念已经发生转变,开始开发新型经皮管理策略和临时干预措施。本文旨在全面回顾心源性休克时出现的瓣膜和结构性心脏病的病理生理学,重点介绍机械循环支持设备和其他管理方式的不断发展。