Division of Cardiology, Columbia University Medical Center, New York, New York, USA; Cardiovascular Research Foundation, New York, New York, USA.
Advanced Heart Failure, Vanderbilt Heart and Vascular Institute, Nashville, Tennessee, USA.
J Am Coll Cardiol. 2024 Aug 27;84(9):832-847. doi: 10.1016/j.jacc.2024.05.061.
Pathologic left ventricular remodeling and valvular heart disease may contribute to the clinical presentation and outcomes of patients presenting with heart failure, and limit the effectiveness of guideline-directed medical therapy. Although surgical interventions including surgical ventricular restoration techniques and valve repair or replacement are effective therapies, there is growing evidence that transcatheter interventions may be options for patients with persistent symptoms of heart failure despite optimal medical therapy, where surgical options may be limited. This scientific statement will review the current available and investigational percutaneous strategies for the management of structural contributors to heart failure: dilated left ventricular cardiomyopathies and valvular heart disease.
病理性左心室重构和瓣膜性心脏病可能导致心力衰竭患者的临床表现和结局,并限制指南指导的药物治疗的效果。尽管包括心脏外科心室修复技术和瓣膜修复或置换在内的手术干预措施是有效的治疗方法,但越来越多的证据表明,对于尽管接受了最佳药物治疗但仍有持续性心力衰竭症状的患者,经皮介入治疗可能是一种选择,而手术治疗的选择可能会受到限制。本科学声明将回顾目前可用于管理心力衰竭结构性病因的经皮策略:扩张性左心室心肌病和瓣膜性心脏病。