治疗射血分数保留型心力衰竭的非药物疗法

IF 7.8 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Circulation: Heart Failure Pub Date : 2024-08-01 Epub Date: 2024-06-18 DOI:10.1161/CIRCHEARTFAILURE.123.011269
Feiyang Tang, Haofu Han, Sheng Fu, Qiming Liu, Shenghua Zhou, Jiapeng Huang, Yichao Xiao
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引用次数: 0

摘要

射血分数保留型心力衰竭(HFpEF)是一种常见的心力衰竭亚型,以左心室舒张功能受损和心肌顺应性下降为特征。由于循证药物治疗 HFpEF 的方法有限,人们对非药物干预作为可行的替代治疗方法的兴趣与日俱增。本综述旨在探讨 HFpEF 的病理生理学,并介绍非药物治疗方法的最新进展,包括非侵入性疗法、侵入性程序和针对合并症的靶向治疗。我们进行了广泛的文献综述,以确定和归纳新出现的高频心衰非药物治疗方案,评估其改善患者预后的潜力。非药物治疗策略,如迷走神经刺激、经皮肺动脉去神经支配、肾脏去神经支配、经导管插入心房分流术和心包切除术,在缓解 HFpEF 症状和改善患者预后方面显示出巨大的潜力。此外,治疗高血压和糖尿病等合并症还能带来额外的治疗效果。这些前沿技术与成熟的运动疗法相结合,为该领域未来的研究和临床应用铺平了道路。非药物干预有望促进 HFpEF 患者的治疗,并加深对这些治疗方法的理解,这将促进新的临床应用,有助于开发更具针对性的疗法。
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Nonpharmacological Approaches to Managing Heart Failure With Preserved Ejection Fraction.

Heart failure with preserved ejection fraction (HFpEF) is a common subtype of heart failure marked by impaired left ventricular diastolic function and decreased myocardial compliance. Given the limited availability of evidence-based pharmacological treatments for HFpEF, there is a growing interest in nonpharmacological interventions as viable therapeutic alternatives. This review aims to explore the pathophysiology of HFpEF and present recent advancements in nonpharmacological management approaches, encompassing noninvasive therapies, invasive procedures and targeted treatments for comorbidities. An extensive literature review was undertaken to identify and synthesize emerging nonpharmacological treatment options for HFpEF, assessing their potential to enhance patient outcomes. Nonpharmacological strategies, such as vagus nerve stimulation, percutaneous pulmonary artery denervation, renal denervation, transcatheter insertion of atrial shunts and pericardial resection, demonstrate promising potential for alleviating HFpEF symptoms and improving patient prognosis. Moreover, addressing comorbidities, such as hypertension and diabetes, may offer additional therapeutic benefits. These cutting-edge techniques, in conjunction with well-established exercise therapies, pave the way for future research and clinical applications in the field. Nonpharmacological interventions hold promise for advancing HFpEF patient care and fostering a deeper understanding of these treatment approaches, which will facilitate new clinical applications and contribute to the development of more targeted therapies.

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来源期刊
Circulation: Heart Failure
Circulation: Heart Failure 医学-心血管系统
CiteScore
12.90
自引率
3.10%
发文量
271
审稿时长
6-12 weeks
期刊介绍: Circulation: Heart Failure focuses on content related to heart failure, mechanical circulatory support, and heart transplant science and medicine. It considers studies conducted in humans or analyses of human data, as well as preclinical studies with direct clinical correlation or relevance. While primarily a clinical journal, it may publish novel basic and preclinical studies that significantly advance the field of heart failure.
期刊最新文献
Natural Language Processing to Adjudicate Heart Failure Hospitalizations in Global Clinical Trials. A Medical Expert System for Intelligent Telemonitoring of Chronic Heart Failure Patients: Preliminary Validation and Perspectives. Comprehensive Proteomics Profiling Identifies Circulating Biomarkers to Distinguish Hypertrophic Cardiomyopathy from Other Cardiomyopathies with Left Ventricular Hypertrophy. Mavacamten: Real-World Experience from 22 Months of the Risk Evaluation and Mitigation Strategy (REMS) Program. Social Determinants of Health and Disparities in Guideline-Directed Medical Therapy Optimization for Heart Failure.
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