Psychological stress in heart failure: a potentially actionable disease modifier.
Psychological stress in heart failure: a potentially actionable disease modifier.
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DOI：
10.1007/s10741-020-10056-8
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发表时间：
2021-05
影响因子：
4.6
通讯作者：
Burg MM
中科院分区：
文献类型：
--
作者：
Harris KM;Jacoby DL;Lampert R;Soucier RJ;Burg MM
心理压力在心力衰竭患者中很常见，部分原因是由于有效的疾病自我管理的复杂性和逐渐恶化的功能限制，包括频繁的症状恶化和住院治疗。新出现的证据表明，经历较高水平压力的心力衰竭患者可能会有更繁重的病程，生活质量下降，不良事件风险增加，并且涉及多种行为和病理生理途径。此外，与心力衰竭相关的生活质量下降可能成为许多患者的生活压力源。本综述的目的是总结有关心力衰竭患者心理应激的科学现状，并讨论可能导致所观察到的影响的途径。还概述了关键的知识空白，包括需要了解暴露于各种心力衰竭相关和日常生活压力源的模式及其对心力衰竭症状和病理生理学的相关影响，以确定压力暴露和疾病相关后果风险增加的患者亚组，以及压力对保留射血分数的心力衰竭患者的特殊影响。压力是一个潜在的可改变的因素，解决这些差距和推进心力衰竭压力科学可能会产生关于改善患者生活质量和结果的可行途径的重要见解。
Psychological stress is common in patients with heart failure, due in part to the complexities of effective disease self-management and progressively worsening functional limitations, including frequent symptom exacerbations and hospitalizations. Emerging evidence suggests that heart failure patients who experience higher levels of stress may have a more burdensome disease course, with diminished quality of life and increased risk for adverse events, and that multiple behavioral and pathophysiological pathways are involved. Furthermore, the reduced quality of life associated with heart failure can serve as a life stressor for many patients. The purpose of this review is to summarize the current state of the science concerning psychological stress in patients with heart failure and to discuss potential pathways responsible for the observed effects. Key knowledge gaps are also outlined, including the need to understand patterns of exposure to various heart failure-related and daily life stressors and their associated effects on heart failure symptoms and pathophysiology, to identify patient subgroups at increased risk for stress exposure and disease-related consequences, and the effect of stress specifically for patients who have heart failure with preserved ejection fraction. Stress is a potentially modifiable factor, and addressing these gaps and advancing the science of stress in heart failure is likely to yield important insights about actionable pathways for improving patient quality of life and outcomes.
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影响因子：
5
作者：
COHEN, S;KAMARCK, T;MERMELSTEIN, R
通讯作者：
MERMELSTEIN, R
影响因子：
37.8
作者：
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39
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3.5
作者：
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通讯作者：
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影响因子：
1.9
作者：
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通讯作者：
Soufer, Robert