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心肌恢复和缓解的病理生物学：从心力衰竭患者的动物模型到临床观察。

The Pathobiology of Myocardial Recovery and Remission: From Animal Models to Clinical Observations in Heart Failure Patients.

机构信息

Washington University School of Medicine, St. Louis, Missouri, US.

出版信息

Methodist Debakey Cardiovasc J. 2024 Aug 20;20(4):16-30. doi: 10.14797/mdcvj.1389. eCollection 2024.

DOI:10.14797/mdcvj.1389
PMID:39184167
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11342835/
Abstract

Heart failure with reduced left ventricular (LV) ejection fraction (HFrEF) is a morbid and life-threatening disease, arising secondary to abnormalities of cardiac structure and function that lead to adverse LV remodeling. Implementation of medical and device therapies results in significant improvements in patient outcomes that are associated with reverse LV remodeling and improved LV ejection fraction. This review provides an overview of the pathobiology of reverse LV remodeling in animal models and in HFrEF patients. We emphasize the differences between myocardial recovery and remission as well as the fragile nature of maintaining a state of myocardial remission.

摘要

射血分数降低的心力衰竭（HFrEF）是一种严重的危及生命的疾病，继发于导致不良左心室重构的心脏结构和功能异常。实施药物和器械治疗可显著改善患者预后，逆转左心室重构，提高左心室射血分数。本文综述了动物模型和 HFrEF 患者左心室重构逆转的病理生理学，强调了心肌恢复和缓解之间的差异，以及维持心肌缓解状态的脆弱性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02b3/11342835/ef74852f9033/mdcvj-20-4-1389-g4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02b3/11342835/6638c6a71772/mdcvj-20-4-1389-g1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02b3/11342835/653746d8b813/mdcvj-20-4-1389-g2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02b3/11342835/2292c7eed141/mdcvj-20-4-1389-g3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02b3/11342835/ef74852f9033/mdcvj-20-4-1389-g4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02b3/11342835/6638c6a71772/mdcvj-20-4-1389-g1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02b3/11342835/653746d8b813/mdcvj-20-4-1389-g2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02b3/11342835/2292c7eed141/mdcvj-20-4-1389-g3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02b3/11342835/ef74852f9033/mdcvj-20-4-1389-g4.jpg

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Circulation. 2023 Aug 15;148(7):613-616. doi: 10.1161/CIRCULATIONAHA.123.064513. Epub 2023 Aug 14.
2
Circulating Angiokines Are Associated With Reverse Remodeling and Outcomes in Chronic Heart Failure.循环血管生成因子与慢性心力衰竭的逆向重构和结局相关。
J Card Fail. 2023 Jun;29(6):896-906. doi: 10.1016/j.cardfail.2022.12.011. Epub 2023 Jan 8.
3
Biomarkers of Myocardial Injury and Remodeling in Heart Failure.心力衰竭中心肌损伤与重塑的生物标志物
J Pers Med. 2022 May 16;12(5):799. doi: 10.3390/jpm12050799.
4
Pirfenidone in heart failure with preserved ejection fraction: a randomized phase 2 trial.吡非尼酮治疗射血分数保留的心力衰竭：一项随机 2 期试验。
Nat Med. 2021 Aug;27(8):1477-1482. doi: 10.1038/s41591-021-01452-0. Epub 2021 Aug 12.
5
A transcriptional switch governs fibroblast activation in heart disease.一个转录开关控制着心脏病中纤维母细胞的激活。
Nature. 2021 Jul;595(7867):438-443. doi: 10.1038/s41586-021-03674-1. Epub 2021 Jun 23.
6
The combination of carboxy-terminal propeptide of procollagen type I blood levels and late gadolinium enhancement at cardiac magnetic resonance provides additional prognostic information in idiopathic dilated cardiomyopathy - A multilevel assessment of myocardial fibrosis in dilated cardiomyopathy.I 型前胶原羧基末端前肽与心脏磁共振钆延迟增强联合检测可为特发性扩张型心肌病提供预后信息——扩张型心肌病心肌纤维化的多层次评估。
Eur J Heart Fail. 2021 Jun;23(6):933-944. doi: 10.1002/ejhf.2201. Epub 2021 Jun 24.
7
Heart Failure With Recovered Left Ventricular Ejection Fraction: JACC Scientific Expert Panel.心力衰竭伴射血分数恢复：JACC 科学专家小组。
J Am Coll Cardiol. 2020 Aug 11;76(6):719-734. doi: 10.1016/j.jacc.2020.05.075.
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Eplerenone prevents an increase in serum carboxy-terminal propeptide of procollagen type I after myocardial infarction complicated by left ventricular dysfunction and/or heart failure.依普利酮可预防心肌梗死后合并左心室功能障碍和/或心力衰竭时血清I型前胶原羧基末端前肽的升高。
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NT-proBNP Goal Achievement Is Associated With Significant Reverse Remodeling and Improved Clinical Outcomes in HFrEF.NT-proBNP 目标达标与 HFrEF 的显著逆重构和改善临床结局相关。
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