Fumarulo Isabella, Stefanini Andrea, Masarone Daniele, Burzotta Francesco, Cameli Matteo, Aspromonte Nadia
Department of Cardiovascular Sciences, Catholic University of the Sacred Heart, Rome 00168, Italy; Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome 00168, Italy.
Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena 53100, Italy.
Curr Probl Cardiol. 2025 Mar;50(3):102971. doi: 10.1016/j.cpcardiol.2024.102971. Epub 2024 Dec 18.
Diagnostic and therapeutic advances in the cardiovascular field have caused a progressive reduction in mortality from acute causes, with an ever-increasing chronicity of cardiovascular pathologies. In recent years, mechanical supports have played a fundamental role, allowing the patient to be stabilized in the most critical phase of acute heart failure (AHF) and acting as a "bridge" for definitive therapies. Heart transplantation (HTx) is the gold-standard treatment for end-stage HF, but it is burdened by a series of critical issues that limit its use, first of all the shortage of grafts. It also requires the patient to take immunosuppressive therapy for life, which exposes him to a greater risk of infectious and oncological diseases. For these reasons, in the last years, mechanical supports are increasingly used as "destination therapy", alternatively to HTx. However, also mechanical supports are not free from critical issues that limit their use. In this review we aim to analyze critical issues and future perspectives of advanced HF therapies.
心血管领域诊断和治疗方法的进步已使急性病因导致的死亡率逐步降低，心血管疾病的慢性化程度却不断增加。近年来，机械支持发挥了重要作用，使患者在急性心力衰竭（AHF）的最关键阶段得以稳定，并作为确定性治疗的“桥梁”。心脏移植（HTx）是终末期心力衰竭的金标准治疗方法，但它存在一系列限制其应用的关键问题，首先是供体短缺。它还要求患者终身接受免疫抑制治疗，这使患者面临更大的感染和肿瘤疾病风险。由于这些原因，近年来，机械支持越来越多地被用作HTx的替代“目标治疗”。然而，机械支持也并非没有限制其应用的关键问题。在本综述中，我们旨在分析晚期心力衰竭治疗的关键问题和未来前景。
