2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease
2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease
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DOI：
10.1016/j.jacc.2017.03.011
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发表时间：
2017-07-11
影响因子：
24
通讯作者：
Hundley, Jody
中科院分区：
文献类型：
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作者：
Nishimura, Rick A.;Otto, Catherine M.;Hundley, Jody
“2014年AHA/ACC心脏瓣膜病患者管理指南”的重点9，10（2014年VHD指南）是成人瓣膜性心脏病（VHD）患者的诊断和管理。随着对瓣膜疾病患者自然史的新认识，诊断成像的进展，自2014年VHD指南发布以来，已经发表了几项随机对照试验（RCT），特别是关于干预的结局。主要变化领域包括经导管主动脉瓣置换术（TAVR）的适应症，原发性和继发性二尖瓣返流（MR）患者的外科治疗，以及人工瓣膜患者的治疗所有建议（新的，修改的，和不变的）为每个临床部分包括提供一个全面的评估文本解释了新的和修改的建议，鉴于先前指南中已被删除或取代的建议不再出现，请参阅完整的-2014年VHD指南的文本版本10，用于支持未变更建议的文本和证据表以及本重点更新中未涉及的临床领域在此重点更新中，将在未来纳入指南全文中之前指南中的建议仍然是最新的，但LOE反映了最初开发时使用的COR/LOE系统，此重点更新中的新建议和修改建议反映了最新的COR/LOE系统，其中LOE B和C被细分为更高的特异性4-7章节编号对应于全文指南章节
The focus of the “2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease” 9, 10 (2014 VHD guideline) was the diagnosis and management of adult patients with valvular heart disease (VHD) The field of VHD is rapidly progressing, with new knowledge of the natural history of patients with valve disease, advances in diagnostic imaging, and improvements in catheter-based and surgical interventions Several randomized controlled trials (RCTs) have been published since the 2014 VHD guideline, particularly with regard to the outcomes of interventions Major areas of change include indications for transcatheter aortic valve replacement (TAVR), surgical management of the patient with primary and secondary mitral regurgitation (MR), and management of patients with valve prostheses All recommendations (new, modified, and unchanged) for each clinical section are included to provide a comprehensive assessment The text explains new and modified recommendations, whereas recommendations from the previous guideline that have been deleted or superseded no longer appear Please consult the full-text version of the 2014 VHD guideline10 for text and evidence tables supporting the unchanged recommendations and for clinical areas not addressed in this focused update Individual recommendations in this focused update will be incorporated into the full-text guideline in the future Recommendations from the prior guideline that remain current have been included for completeness but the LOE reflects the COR/LOE system used when initially developed New and modified recommendations in this focused update reflect the latest COR/LOE system, in which LOE B and C are subcategorized for greater specificity 4–7 The section numbers correspond to the full-text guideline sections