Pathophysiology of Heart Failure
Pathophysiology of Heart Failure
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DOI：
10.1002/cphy.c140055
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发表时间：
2016-01-01
影响因子：
5.8
通讯作者：
Frantz, Stefan
中科院分区：
文献类型：
--
作者：
Tanai, Edit;Frantz, Stefan
心力衰竭被认为是现代世界的流行病，影响约1%至2%的成年人口。它是一种多因素的全身性疾病，在心脏损伤后，结构、神经体液、细胞和分子机制被激活，并作为一个网络来维持生理功能。这些协调、复杂的过程导致过度的容量超负荷、交感神经活动增加、循环重新分布，并导致不同的、平行发展的临床体征和症状。这些体征和症状总结为一个非特异性的临床图片;因此，侵入性和非侵入性诊断工具被用来获得准确的诊断和指定的根本原因。心力衰竭最重要的结局决定因素是其持续进展。不断优化的药物治疗方案，新的目标，以及对这些过程的精细调节，试图将这些补偿机制保持在生理范围内。除药物治疗外，介入和手术治疗为心力衰竭的治疗提供了新的机会。为了优化和建立这些和新的治疗方法，基本上需要对潜在机制的完整和全面的理解。除了诊断和治疗外，还应努力通过治疗危险因素或识别和跟踪危险人群来更好地预防心力衰竭。心力衰竭的病理生理学的这一总结试图给出一个紧凑的概述的基本机制和新的展开，渐进的心力衰竭理论，有助于更全面的了解疾病。(C)2016美国生理学会。
Heart failure is considered an epidemic disease in the modern world affecting approximately 1% to 2% of adult population. It presents a multifactorial, systemic disease, in which-after cardiac injury-structural, neurohumoral, cellular, and molecular mechanisms are activated and act as a network to maintain physiological functioning. These coordinated, complex processes lead to excessive volume overload, increased sympathetic activity, circulation redistribution, and result in different, parallel developing clinical signs and symptoms. These signs and symptoms sum up to an unspecific clinical picture; thus invasive and noninvasive diagnostic tools are used to get an accurate diagnosis and to specify the underlying cause. The most important, outcome determining factor in heart failure is its constant progression. Constant optimizing of pharmatherapeutical regimes, novel targets, and fine regulation of these processes try to keep these compensatory mechanisms in a physiological range. Beside pharmacological therapy, interventional and surgical therapy options give new chances in the management of heart failure. For the optimization and establishment of these and novel therapeutical approaches, complete and comprehensive understanding of the underlying mechanisms is essentially needed. Besides diagnosis and treatment, efforts should be made for better prevention in heart failure by treatment of risk factors, or identifying and following risk groups. This summary of the pathophysiology of heart failure tries to give a compact overview of basic mechanisms and of the novel unfolding, progressive theory of heart failure to contribute to a more comprehensive knowledge of the disease. (C) 2016 American Physiological Society.