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意大利心脏病学国家协会立场文件:射血分数保留的心力衰竭的诊断与治疗

ANMCO position paper: diagnosis and treatment of heart failure with preserved systolic function.

作者信息

Iacovoni Attilio, Navazio Alessandro, De Luca Leonardo, Gori Mauro, Corda Marco, Milli Massimo, Iacoviello Massimo, Di Lenarda Andrea, Di Tano Giuseppe, Marini Marco, Iorio Annamaria, Mortara Andrea, Mureddu Gian Francesco, Zilio Filippo, Chimenti Cristina, Cipriani Manlio Gianni, Senni Michele, Bilato Claudio, Di Marco Massimo, Geraci Giovanna, Pascale Vittorio, Riccio Carmine, Scicchitano Pietro, Tizzani Emanuele, Gulizia Michele Massimo, Nardi Federico, Gabrielli Domenico, Colivicchi Furio, Grimaldi Massimo, Oliva Fabrizio

机构信息

S.S.D. Chirurgia dei Trapianti e del Trattamento Chirurgico dello Scompenso, Dipartimento Cardiovascolare, ASST Papa Giovanni XXIII, Piazza OMS 1, Bergamo 24127, Italy.

S.O.C. Cardiologia Ospedaliera, Presidio Ospedaliero Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia-IRCCS, Reggio Emilia, Italy.

出版信息

Eur Heart J Suppl. 2025 May 15;27(Suppl 5):v216-v246. doi: 10.1093/eurheartjsupp/suaf070. eCollection 2025 May.

Abstract

Heart failure is the leading cardiovascular cause of hospitalization with an increasing prevalence, especially in older patients. About 50% of patients with heart failure have preserved ventricular function, a form of heart failure that, until a few years ago, was orphaned by pharmacological treatments effective in reducing hospitalization and mortality. New trials, which have tested the use of gliflozins in patients with heart failure with preserved ejection fraction (HFpEF), have for the first time demonstrated their effectiveness in changing the natural history of this insidious and frequent form of heart failure. Therefore, diagnosing those patients early is crucial to provide the best treatment. Moreover, the diagnosis is influenced by the patient's comorbidities, and some HFpEF patients have symptoms common to other rare diseases that, if unrecognized, develop an unfavourable prognosis. This position paper aims to provide the clinician with a useful tool for diagnosing and treating patients with HFpEF, guiding the clinician towards the most appropriate diagnostic and therapeutic pathway.

摘要

心力衰竭是导致住院的主要心血管病因,其患病率不断上升,在老年患者中尤为如此。约50%的心力衰竭患者心室功能保留,这种心力衰竭形式在几年前还缺乏能有效降低住院率和死亡率的药物治疗。新的试验对钠-葡萄糖协同转运蛋白2抑制剂(SGLT2i)在射血分数保留的心力衰竭(HFpEF)患者中的应用进行了测试,首次证明了它们在改变这种隐匿且常见的心力衰竭自然病程方面的有效性。因此,早期诊断这些患者对于提供最佳治疗至关重要。此外,诊断受患者合并症的影响,一些HFpEF患者有其他罕见疾病共有的症状,如果未被识别,会导致不良预后。本立场文件旨在为临床医生提供一个诊断和治疗HFpEF患者的有用工具,引导临床医生走向最合适的诊断和治疗途径。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d545/12078774/66eb1932220d/suaf070f1.jpg

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