Hlaváček Daniel, Haluzík Martin, Mahrík Jakub, Popivnyak Ganna, Kasperová Barbora J, Ivák Peter
Department of Cardiovascular Surgery, Institute for Clinical and Experimental Medicine, 140 21 Prague, Czech Republic.
Department of Physiology, Third Faculty of Medicine, Charles University, 100 00 Prague, Czech Republic.
Rev Cardiovasc Med. 2024 Oct 31;25(11):388. doi: 10.31083/j.rcm2511388. eCollection 2024 Nov.
Heart failure (HF) is a clinical syndrome characterized by the inability of the heart to provide adequate perfusion to tissues and organs, resulting in typical symptoms such as fatigue, dyspnea, dyspepsia, or swelling due to decreased cardiac output. With its increasing prevalence, heart failure has become one of the leading causes of morbidity and mortality worldwide, imposing a significant burden on the population by reducing long-term life expectancy and raising hospital costs. Indeed, over 20 million people worldwide suffer from heart failure, with a 5-year mortality rate of 60-70%. As heart failure progresses, various structural and metabolic changes occur within the myocardium and organ systems. In the past two decades, therapeutic options for heart failure patients have significantly expanded. In addition to novel pharmacological treatment, advanced surgical methods such as heart transplantation (HTx) and the implantation of durable left ventricular assist devices (LVADs) are available for patients with end-stage heart failure. This review discusses the pathophysiological aspects and metabolic consequences of heart failure and metabolic changes, as well as the benefits and challenges of implanting a left ventricular assist device. Furthermore, future targets for heart failure diagnostics and therapy will be highlighted.
心力衰竭（HF）是一种临床综合征，其特征是心脏无法为组织和器官提供足够的灌注，导致典型症状，如因心输出量减少而出现疲劳、呼吸困难、消化不良或肿胀。随着其患病率的不断上升，心力衰竭已成为全球发病和死亡的主要原因之一，通过降低长期预期寿命和增加医院成本，给人群带来了沉重负担。事实上，全球超过2000万人患有心力衰竭，5年死亡率为60%-70%。随着心力衰竭的进展，心肌和器官系统会发生各种结构和代谢变化。在过去二十年中，心力衰竭患者的治疗选择显著增加。除了新型药物治疗外，晚期手术方法，如心脏移植（HTx）和植入耐用的左心室辅助装置（LVADs），也可供终末期心力衰竭患者使用。本综述讨论了心力衰竭的病理生理方面、代谢后果和代谢变化，以及植入左心室辅助装置的益处和挑战。此外，还将强调心力衰竭诊断和治疗的未来目标。
