Department of Internal Medicine, University of Texas Medical Branch, 301 University Blvd, 4.174 John Sealy Annex, Galveston, TX, 77555, USA.
Department of Pediatrics, University of Texas Medical Branch, Galveston, TX, USA.
Heart Fail Rev. 2024 Nov;29(6):1175-1185. doi: 10.1007/s10741-024-10428-4. Epub 2024 Aug 12.
Congenital heart disease (CHD) is the most common global congenital defect affecting over 2.4 million individuals in the United States. Ongoing medical and surgical advancements have improved the survival of children with CHD leading to a shift where, as of 2010, adults constitute two-thirds of the CHD patient population. The increasing number and aging of adult congenital heart disease (ACHD) patients present a clinical challenge due to heightened complexity, morbidity, and mortality. Studies indicate that 1 in 13 ACHD patients will develop heart failure (HF) in their lifetime. ACHD-HF patients experience more frequent emergency department visits, higher hospitalization rates, longer hospital stays, and higher mortality compared to non-ACHD patients with heart failure (non-ACHD-HF). Despite HF being the leading cause of death in ACHD patients, there is a notable gap in evidence regarding treatment. While guideline-directed medical therapy (GDMT) has been extensively studied in non-ACHD-HF, research specific to ACHD-HF individuals is limited. This article aims to comprehensively review available literature addressing the pharmacological treatment of ACHD-HF.
先天性心脏病（CHD）是全球最常见的先天性缺陷，影响美国超过 240 万人。不断发展的医学和外科技术进步提高了 CHD 患儿的生存率，导致自 2010 年以来，成年人占 CHD 患者群体的三分之二。由于复杂性、发病率和死亡率的增加，越来越多的成年先天性心脏病（ACHD）患者和老龄化患者带来了临床挑战。研究表明，13 名 ACHD 患者中就有 1 名会在其一生中发展为心力衰竭（HF）。与非 ACHD 心力衰竭（non-ACHD-HF）患者相比，ACHD-HF 患者更频繁地到急诊就诊，住院率更高，住院时间更长，死亡率更高。尽管 HF 是 ACHD 患者的主要死亡原因，但在治疗方面存在明显的证据差距。虽然指南指导的药物治疗（GDMT）在非 ACHD-HF 中得到了广泛研究，但针对 ACHD-HF 个体的研究有限。本文旨在全面回顾现有文献，探讨 ACHD-HF 的药物治疗。
