Acute heart failure.
Acute heart failure.
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DOI：
10.1038/s41572-020-0151-7
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发表时间：
2020-03-05
期刊：
影响因子：
--
通讯作者：
Mebazaa A
中科院分区：
文献类型：
--
作者：
Arrigo M;Jessup M;Mullens W;Reza N;Shah AM;Sliwa K;Mebazaa A
急性心力衰竭（AHF）是一种定义为新发（新发心力衰竭（HF））或HF症状和体征恶化（急性失代偿性心力衰竭（ADHF））的综合征，主要与全身充血相关。在存在潜在的结构性或功能性心功能不全（无论是慢性ADHF还是未确诊的新发HF）的情况下，一种或多种促发因素可诱导AHF，尽管有时新发HF可直接由新发心功能不全（最常见的是急性冠脉综合征）的发作引起。尽管导致相似的临床表现，潜在的心脏疾病和诱发因素可能差异很大，因此，AHF的病理生理学是高度异质性的。左心室舒张或收缩功能障碍导致前负荷和后负荷增加，进而导致肺充血。液体潴留和再分布导致全身充血，最终由于灌注不足而导致器官功能障碍。目前AHF的治疗主要是对症治疗，以缓解充血药物为中心，最好是根据最初的血液动力学状态进行调整，很少考虑潜在的病理生理学特征。因此，AHF仍然与高死亡率和再入院率相关。增加住院管理的个体化，包括针对致病因素的治疗，以及出院后继续治疗以改善长期结局的需求尚未得到满足。
Acute heart failure (AHF) is a syndrome defined as the new onset (de novo heart failure (HF)) or worsening (acutely decompensated heart failure (ADHF)) of symptoms and signs of HF, mostly related to systemic congestion. In the presence of an underlying structural or functional cardiac dysfunction (whether chronic in ADHF or undiagnosed in de novo HF), one or more precipitating factors can induce AHF, although sometimes de novo HF can result directly from the onset of a new cardiac dysfunction, most frequently an acute coronary syndrome. Despite leading to similar clinical presentations, the underlying cardiac disease and precipitating factors may vary greatly and, therefore, the pathophysiology of AHF is highly heterogeneous. Left ventricular diastolic or systolic dysfunction results in increased preload and afterload, which in turn lead to pulmonary congestion. Fluid retention and redistribution result in systemic congestion, eventually causing organ dysfunction due to hypoperfusion. Current treatment of AHF is mostly symptomatic, centred on decongestive drugs, at best tailored according to the initial haemodynamic status with little regard to the underlying pathophysiological particularities. As a consequence, AHF is still associated with high mortality and hospital readmission rates. There is an unmet need for increased individualization of in-hospital management, including treatments targeting the causative factors, and continuation of treatment after hospital discharge to improve long-term outcomes.
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影响因子：
1.6
作者：
Arrigo, Mattia;Parissis, John T.;Mebazaa, Alexandre
通讯作者：
Mebazaa, Alexandre
DOI：
10.1056/nejmoa1010029
发表时间：
2010-12-09
期刊：
The New England journal of medicine
影响因子：
--
作者：
Chaudhry SI;Mattera JA;Curtis JP;Spertus JA;Herrin J;Lin Z;Phillips CO;Hodshon BV;Cooper LS;Krumholz HM
通讯作者：
Krumholz HM
影响因子：
9.7
作者：
Adamson, Philip B.;Abraham, William T.;Stevenson, Lynne Warner
通讯作者：
Stevenson, Lynne Warner
影响因子：
168.9
作者：
Abraham, William T.;Adamson, Philip B.;Yadav, Jay S.
通讯作者：
Yadav, Jay S.
影响因子：
24
作者：
Costanzo, Maria Rosa;Guglin, Maya E.;Sobotka, Paul A.
通讯作者：
Sobotka, Paul A.