新型正性肌力药物获得认可
急性心衰使用SGLT2i同样获益
SOLOIST-WHF:SGLT2i在糖尿病合并近期恶化心衰中的作用
SGLT2i:改善HFpEF预后的首个答案
心衰管理、康复干预的新证据
心衰定义、分类、治疗方面的指南更新
心衰是一种临床综合征,目前或既往存在:
由心脏结构和/或功能异常(EF<50%,心脏扩大,E/E’>15,中度/重度心室肥厚,中度/重度心脏瓣膜狭窄或反流)引起的心衰症状和/或体征;
同时合并以下情况中的至少一项:
利钠肽水平升高;
存在心源性肺循环或体循环淤血的客观证据,包括影像学检查(如胸片、超声心动图等)、静息或负荷(如锻炼)血流动力学监测(如右心导管、肺动脉导管)等。
文件对基于左心室射血分数(LVEF)的心衰分类进行了更新:
射血分数降低的心衰(HFrEF):LVEF≤40%;
射血分数轻度降低的心衰(HFmrEF):LVEF 41%-49%;
射血分数保留的心衰(HFpEF):LVEF≥50%;
射血分数改善的心衰(HFimpEF):基线LVEF≤40%,LVEF较基线水平提高超过10个百分点,且再次测量时LVEF>40%。
021 ESC急慢性心力衰竭诊断和治疗指南
将术语“射血分数中间值的心力衰竭”更改为“射血分数轻度降低的心力衰竭”(HFmrEF);
提供了一种新的简化HFrEF治疗流程;
根据表型增加了HFrEF的治疗流程;
修正了急性心力衰竭的分类;
更新了大多数非心血管合并症的治疗方法,包括糖尿病、高钾血症、铁缺乏和癌症;
心肌病的更新,包括基因检测和新疗法的作用;
增加了关键质量指标。
参考文献:(上下滑动查看更多)
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(来源:《国际循环》编辑部)