摘要
射血分数改善型心力衰竭(heart failure with improved ejection fraction,HFimpEF)是心力衰竭患者中的特殊类型,近年来的研究表明,左心室射血分数(left ventricular ejection fraction,LVEF)在接受治疗后可显著改善。根据最新的《中国心力衰竭诊断和治疗指南2024》,HFimpEF的定义为既往LVEF≤40%,治疗后LVEF > 40%并增加≥10%。HFimpEF的病理生理特点包括心室重塑、心室逆重构、心肌缓解和恢复,且其患者往往相对年轻,并发症较少,预后相对较好。研究显示HFimpEF患者的5年生存率高达80%~90%,高于持续性射血分数降低的心力衰竭(heart failure with reduced ejection fraction,HFrEF)患者。治疗方面,建议继续应用心力衰竭的一般药物治疗[指南导向的药物治疗(guideline-directed medical therapy,GDMT)]方案,以防止心力衰竭复发和左心功能障碍,包括血管紧张素转换酶抑制剂(angiotensin-converting enzyme inhibitor,ACEI)、β受体阻滞剂和醛固酮拮抗剂等。同时,器械治疗和适当的运动干预也被证实能改善患者生活质量并降低再住院率。文章旨在总结HFimpEF的最新研究进展,为临床提供参考,以提高对该病种的认识和治疗效果。
Heart failure with improved ejection fraction(HFimpEF)is a special type of heart failure among patients.Recent studies have shown that the left ventricular ejection fraction(LVEF)can be significantly improved after treatment.According to the latest"Guidelines for the Diagnosis and Treatment of Heart Failure in China 2024",HFimpEF is defined as a history of LVEF≤40%,with a post-treatment LVEF>40%and an increase of 10%.The pathophysiological characteristics of HFimpEF include ventricular remodeling,reverse remodeling,myocardial relief,and recovery.Patients with HFimpEF tend to be younger and have fewer comorbidities,resulting in a better prognosis.Studies indicate that the five-year survival rate for HFimpEF patients can reach 80%-90%,which is significantly higher than that of persistent heart failure with reduced ejection fraction(HFrEF)patients.In terms of treatment,it is recommended to continue applying the general drug treatment[guideline-directed medical therapy(GDMT)]plan for heart failure to prevent recurrence of heart failure and left ventricular dysfunction,which includes angiotensin-converting enzyme inhibitor(ACEI),β-blockers,and aldosterone antagonists.Additionally,device therapy and appropriate exercise interventions have been shown to improve patients'quality of life and reduce readmission rates.This article aims to summarize the latest research progress of HFimpEF,provide references for clinical practice,and enhance the understanding and treatment effect of this disease.
作者
马玉骁
MA Yuxiao(Deartment of Emergency,People's Hospital of Rizhao,Rizhao Shandong 276800,China)
出处
《中国卫生标准管理》
2025年第18期179-182,共4页
China Health Standard Management
关键词
射血分数改善型
心力衰竭
药物
心功能
左心室射血分数
研究进展
improved ejection fraction
heart failure
medicine
cardiac function
left ventricular ejection fraction
research progress
