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对抗心力衰竭机制是使患者消肿同时改善预后的最有效方法。

Counteracting the Mechanisms of Heart Failure is the Most Effective Way to Decongest Patients while Improving Outcomes.

作者信息

Čelutkienė Jelena, Mebazaa Alexandre, Biegus Jan, Ponikowski Piotr, Davison Beth, Cotter Gad

机构信息

Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University Vilnius, Lithuania.

INSERM UMR-S 942 (MASCOT), Université Paris Cité Paris, France.

出版信息

Card Fail Rev. 2025 Feb 4;11:e02. doi: 10.15420/cfr.2024.19. eCollection 2025.

DOI:10.15420/cfr.2024.19
PMID:40018521
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11865671/
Abstract

Diuretic therapy is not associated with improved outcomes in heart failure and may cause significant side effects. Counteracting the core pathophysiological mechanisms of heart failure through neurohormonal blockade while reducing reliance on diuretics is potentially the most effective method of decongestion.

摘要

利尿剂治疗与心力衰竭患者预后改善无关，且可能会引起严重的副作用。通过神经激素阻断来对抗心力衰竭的核心病理生理机制，同时减少对利尿剂的依赖，可能是最有效的消肿方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb19/11865671/ae132b24019b/cfr-11-e02-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb19/11865671/ae132b24019b/cfr-11-e02-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb19/11865671/ae132b24019b/cfr-11-e02-g001.jpg

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本文引用的文献

1
The Effects of Burst Steroid Therapy on Short-term Decongestion in Acute Heart Failure Patients With Pro-inflammatory Activation: A Post Hoc Analysis of the CORTAHF Randomized, Open-label, Pilot Trial.冲击性类固醇疗法对伴有促炎激活的急性心力衰竭患者短期充血缓解的影响：CORTAHF随机、开放标签、试点试验的事后分析
J Card Fail. 2025 Feb;31(2):354-366. doi: 10.1016/j.cardfail.2024.09.002. Epub 2024 Sep 29.
2
Decongestion in acute heart failure: Is it time to change diuretic-centred paradigm?急性心力衰竭的利尿消肿：是否到了改变以利尿剂为中心的治疗模式的时候？
Eur J Heart Fail. 2024 Oct;26(10):2094-2106. doi: 10.1002/ejhf.3423. Epub 2024 Aug 21.
3
Effects of Rapid Uptitration of Neurohormonal Blockade on Effective, Sustainable Decongestion and Outcomes in STRONG-HF.
神经激素阻断的快速滴定对 STRONG-HF 中的有效、可持续性充血消退和结局的影响。
J Am Coll Cardiol. 2024 Jul 23;84(4):323-336. doi: 10.1016/j.jacc.2024.04.055.
4
Semaglutide and diuretic use in obesity-related heart failure with preserved ejection fraction: a pooled analysis of the STEP-HFpEF and STEP-HFpEF-DM trials.司美格鲁肽和利尿剂在射血分数保留型心力衰竭合并肥胖中的应用：STEP-HFpEF 和 STEP-HFpEF-DM 试验的汇总分析。
Eur Heart J. 2024 Sep 14;45(35):3254-3269. doi: 10.1093/eurheartj/ehae322.
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Reduced congestion and improved response to a fluid/sodium challenge in chronic heart failure patients after initiation of sacubitril/valsartan: The NATRIUM-HF study.沙库巴曲缬沙坦治疗慢性心力衰竭患者后，减少充血并改善对液体/钠挑战的反应：NATRIUM-HF 研究。
Eur J Heart Fail. 2024 Jul;26(7):1507-1517. doi: 10.1002/ejhf.3265. Epub 2024 May 9.
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Semaglutide versus placebo in people with obesity-related heart failure with preserved ejection fraction: a pooled analysis of the STEP-HFpEF and STEP-HFpEF DM randomised trials.司美格鲁肽与安慰剂治疗射血分数保留的肥胖相关性心力衰竭患者的比较：STEP-HFpEF和STEP-HFpEF DM随机试验的汇总分析
Lancet. 2024 Apr 27;403(10437):1635-1648. doi: 10.1016/S0140-6736(24)00469-0. Epub 2024 Apr 7.
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