Icahn School of Medicine at Mount Sinai, New York, New York, US.
Icahn School of Medicine at Mount Sinai, Mount Sinai Fuster Heart Hospital, The Mount Sinai Hospital, New York, New York, US.
Methodist Debakey Cardiovasc J. 2024 Aug 20;20(4):98-108. doi: 10.14797/mdcvj.1416. eCollection 2024.
Heart failure poses a significant challenge to healthcare systems and society at large, mainly due to its increasing prevalence among the aging population and its association with frequent hospitalizations with high mortality rates. At its core, heart failure management seeks to emphasize myocardial recovery across the spectrum of disease, from acute cardiogenic shock to ambulatory heart failure, with care ranging from consideration of mechanical circulatory support to medication optimization. In this review, we propose a definition of "recovery" that extends beyond the restoration of normal myocardial dynamics to the entire human organism, ultimately improving functional capacity and clinical outcomes. Prioritizing this more holistic definition of "recovery" allows a broader representation of the spectrum of disease and corresponding management that falls under the "heart failure" umbrella. In so doing, a more synchronized delivery of care across settings and disciplines may be feasible for the modern patient living with heart failure.
心力衰竭给医疗系统和整个社会带来了重大挑战，主要是因为其在老年人口中的发病率不断上升，以及与频繁住院和高死亡率相关。心力衰竭的管理核心在于强调心肌在从急性心源性休克到门诊心力衰竭等疾病谱中的恢复，从考虑机械循环支持到优化药物治疗，涵盖了从发病到治疗的各个阶段。在这篇综述中，我们提出了一个“恢复”的定义，它不仅限于恢复正常心肌动力学，而是延伸到整个人体，最终提高功能能力和临床结局。优先考虑这种更全面的“恢复”定义，可以更广泛地代表“心力衰竭”涵盖的疾病谱及其相应的管理。这样，在现代心力衰竭患者的治疗中，不同医疗机构和学科之间的治疗方案就可以更加协调一致。
