急性失代偿期心力衰竭的治疗进展
Advances in Treatment of Acute Decompensated Heart Failure
DOI: 10.12677/ACM.2023.132253, PDF,   
作者: 李 欢*, 刘地川#：重庆医科大学附属第二医院心血管内科，重庆
关键词: 急性失代偿期心力衰竭；治疗进展；Acute Decompensated Heart Failure； Treatment Progress
摘要: 急性失代偿期心力衰竭(ADHF)是急性心力衰竭(AHF)最常见的表现形式，随着医疗技术水平的不断进步，治疗心力衰竭的新药不断被批准上市、治疗方案不断优化调整。目前ADHF的治疗目的主要包括稳定血流动力学、缓解症状和预防短期发病率和死亡率，常见的治疗包括血管扩张剂、正性肌力药、醛固酮受体拮抗剂等相关药物及机械通气、血液净化等非药物辅助治疗方法。由于ADHF的病理生理机制尚未阐明，ADHF的标准治疗方案缺乏大规模临床试验、确切的证据等研究及报道，本文从药物及非药物治疗等方面综述了ADHF的治疗现状及研究进展。
Abstract: Acute decompensated heart failure (ADHF) is the most common manifestation of acute heart failure (AHF), and with the continuous progress of medical technology, new drugs for heart failure continue to be approved and marketed, and treatment regimens continue to be optimized and adjusted. The common treatments include vasodilators, positive inotropic agents, aldosterone receptor antago-nists and other related drugs, as well as non-pharmacological adjuvant therapies such as mechani-cal ventilation and ultrafiltration, etc. Because the pathophysiological mechanisms of ADHF have not been elucidated, and the treatment protocols for ADHF lack large-scale clinical trials and precise evidence, this paper reviews the current status and research progress of ADHF treatment from the aspects of drug and non-drug treatments.
文章引用：李欢, 刘地川. 急性失代偿期心力衰竭的治疗进展[J]. 临床医学进展, 2023, 13(2): 1825-1831. https://doi.org/10.12677/ACM.2023.132253

参考文献

[1] Njoroge, J.N. and Teerlink, J.R. (2021) Pathophysiology and Therapeutic Approaches to Acute Decompensated Heart Failure. Circulation Research, 128, 1468-1486. [Google Scholar] [CrossRef] 
[2] Xanthopoulos, A., Butler, J., Parissis, J., et al. (2020) Acutely Decompensated versus Acute Heart Failure: Two Different Entities. Heart Failure Reviews, 25, 907-916. [Google Scholar] [CrossRef] [PubMed]
[3] Raj, L., Maidman, S.D. and Adhyaru, B. (2020) Inpatient Man-agement of Acute Decompensated Heart Failure. Postgraduate Medical Journal, 96, 33-42. [Google Scholar] [CrossRef] [PubMed]
[4] Kurmani, S. and Squire, I. (2017) Acute Heart Failure: Definition, Classification and Epidemiology. Current Heart Failure Reports, 14, 385-392. [Google Scholar] [CrossRef] [PubMed]
[5] Burger, A., Horton, D., Lejemtel, T., et al. (2002) Effect of Nesiritide (B-Type Natriuretic Peptide) and Dobutamine on Ventricular Arrhythmias in the Treatment of Patients with Acutely Decompensated Congestive Heart Failure: The PRECEDENT Study. American Heart Journal, 144, 1102-1108. [Google Scholar] [CrossRef] [PubMed]
[6] Parissis, J.T., Rafouli-Stergiou, P., Paraskevaidis, I. and Mebazaa, A. (2009) Levosimendan: From Basic Science to Clinical Practice. Heart Failure Reviews, 14, 265-275. [Google Scholar] [CrossRef] [PubMed]
[7] Cohen-Solal, A., Logeart, D., Huang, B., et al. (2009) Lowered B-Type Natriuretic Peptide in Response to Levosimendan or Dobutamine Treatment Is Associated with Improved Sur-vival in Patients with Severe Acutely Decompensated Heart Failure. Journal of the American College of Cardiology, 53, 2343-2348. [Google Scholar] [CrossRef] [PubMed]
[8] Landoni, G., Biondi-Zoccai, G., Greco, M., et al. (2012) Effects of Levosimendan on Mortality and Hospitalization. A Meta-Analysis of Randomized Controlled Studies. Critical Care Medicine, 40, 634-646. [Google Scholar] [CrossRef] 
[9] Forzano, I., Mone, P., Mottola, G., et al. (2022) Efficacy of the New Inotropic Agent Istaroxime in Acute Heart Failure. Journal of Clinical Medicine, 11, Article No. 7503. [Google Scholar] [CrossRef] [PubMed]
[10] Sabbah, H.N., Imai, M., Cowart, D., et al. (2007) Hemodynamic Prop-erties of a New-Generation Positive Luso-Inotropic Agent for the Acute Treatment of Advanced Heart Failure. The American Journal of Cardiology, 99, S41-S46. [Google Scholar] [CrossRef] [PubMed]
[11] Feil, R., Lohmann, S., De Jonge, H., Walter, U. and Hofmann, F. (2003) Cyclic GMP-Dependent Protein Kinases and the Cardiovascular System: Insights from Genetically Modified Mice. Circulation Research, 93, 907-916. [Google Scholar] [CrossRef] 
[12] Burger, A.J. (2005) A Review of the Renal and Neu-rohormonal Effects of B-Type Natriuretic Peptide. Congestive Heart Failure, 11, 30-38. [Google Scholar] [CrossRef] [PubMed]
[13] Kapoun, A.M., Liang, F., O’Young, G., et al. (2004) B-Type Natriuretic Peptide Exerts Broad Functional Opposition to Transforming Growth Factor-β in Primary Human Cardiac Fibroblasts: Fibrosis, Myofibroblast Conversion, Proliferation, and Inflammation. Circulation Research, 94, 453-461. [Google Scholar] [CrossRef] 
[14] Mitter, S.S. and Pinney, S.P. (2020) Ad-vances in the Management of Acute Decompensated Heart Failure. Medical Clinics of North America, 104, 601-14. [Google Scholar] [CrossRef] [PubMed]
[15] Grygier, M., Araszkiewicz, A., Lesiak, M. and Grajek, S. (2013) Effect of New Method of Intracoronary Adenosine Injection during Primary Percutaneous Coronary Intervention on Mi-crovascular Reperfusion Injury—Clinical Outcome and 1-Year Follow-up. Cardiology, 124, 199-206. [Google Scholar] [CrossRef] [PubMed]
[16] Zhu, X.Q., Hong, .S.H, Lin, X.H., Chen, L.L. and Li, Y.H. (2014) Changes in Cardiac Aldosterone and Its Synthase in Rats with Chronic Heart Failure: An Intervention Study of Long-Term Treatment with Recombinant Human Brain Natriuretic Peptide. Brazilian Journal of Medical and Biological Research/Revista Brasileira de Pesquisas Medicas e Biologicas, 47, 646-654. [Google Scholar] [CrossRef] [PubMed]
[17] O’Connor, C.M., Stough, W.G., Gallup, D.S., Hasselblad, V. and Gheorghiade, M. (2005) Demographics, Clinical Characteristics, and Outcomes of Patients Hospitalized for Decom-pensated Heart Failure: Observations from the IMPACT-HF Registry. Journal of Cardiac Failure, 11, 200-205. [Google Scholar] [CrossRef] [PubMed]
[18] Gheorghiade, M., Gattis, W., O’Connor, C.M., et al. (2004) Ef-fects of Tolvaptan, a Vasopressin Antagonist, in Patients Hospitalized with Worsening Heart Failure: A Randomized Controlled Trial. JAMA, 291, 1963-19971. [Google Scholar] [CrossRef] [PubMed]
[19] Fukunami, M., Matsuzaki, M., Hori, M., et al. (2011) Efficacy and Safety of Tolvaptan in Heart Failure Patients with Sustained Volume Overload despite the Use of Conventional Diuretics: A Phase III Open-Label Study. Cardiovascular Drugs and Therapy, 25, 47-56. [Google Scholar] [CrossRef] [PubMed]
[20] Mori, T., Oba, I., Koizumi, K., et al. (2013) Beneficial Role of Tolvaptan in the Control of Body Fluids without Reductions in Residual Renal Function in Patients Undergoing Perito-neal Dialysis. Advances in Peritoneal Dialysis, 29, 33-37.
[21] Sargento, L., Satendra, M., Longo, S., Lousada, N. and dos Reis, R.P. (2014) Heart Rate Reduction with Ivabradine in Patients with Acute Decompensated Systolic Heart Failure. American Journal of Cardiovascular Drugs, 14, 229-235. [Google Scholar] [CrossRef] [PubMed]
[22] Custodis, F., Reil, J.-C., Laufs, U. and Böhm, M. (2013) Heart Rate: A Global Target for Cardiovascular Disease and Therapy Along the Cardiovascular Disease Continuum. Journal of Cardiology, 62, 183-187. [Google Scholar] [CrossRef] [PubMed]
[23] Böhm, M., Swedberg, K., Komajda, M., et al. (2010) Heart Rate as a Risk Factor in Chronic Heart Failure (SHIFT): The Association between Heart Rate and Outcomes in a Randomised Placebo-Controlled Trial. Lancet, 376, 886-894. [Google Scholar] [CrossRef] 
[24] Habal, M.V., Liu, P.P., Austin, P.C., et al. (2014) Associa-tion of Heart Rate at Hospital Discharge with Mortality and Hospitalizations in Patients with Heart Failure. Circulation: Heart Failure, 7, 12-20. [Google Scholar] [CrossRef] 
[25] Borer, J.S., Böhm, M., Ford, I., et al. (2014) Ef-ficacy and Safety of Ivabradine in Patients with Severe Chronic Systolic Heart Failure (from the SHIFT Study). The American Journal of Cardiology, 113, 497-503. [Google Scholar] [CrossRef] [PubMed]
[26] Böhm, M., Borer, J.S., Camm, J., et al. (2015) Twen-ty-Four-Hour Heart Rate Lowering with Ivabradine in Chronic Heart Failure: Insights from the SHIFT Holter Substudy. European Journal of Heart Failure, 17, 518-526. [Google Scholar] [CrossRef] [PubMed]
[27] Böhm, M., Robertson, M., Ford, I., et al. (2015) Influence of Cardiovascular and Noncardiovascular Co-morbidities on Outcomes and Treatment Effect of Heart Rate Reduction with Ivabradine in Stable Heart Failure (from the SHIFT Trial). The American Journal of Cardiology, 116, 1890-1897. [Google Scholar] [CrossRef] [PubMed]
[28] Vagnarelli, F., Marini, M., Caretta, G., et al. (2017) [Noninva-sive Ventilation: General Characteristics, Indications, and Review of the Literature]. Giornale Italiano di Cardiologia, 18, 496-504. (In Italian)
[29] Moss, M., Nordon-Craft, A., Malone, D., et al. (2016) A Randomized Trial of an Intensive Physical Therapy Program for Patients with Acute Respiratory Failure. American Journal of Respiratory and Critical Care Medicine, 193, 1101-1110. [Google Scholar] [CrossRef] 
[30] Thille, A.W., Esteban, A., Fernández-Segoviano, P., et al. (2013) Comparison of the Berlin Definition for Acute Respiratory Distress Syndrome with Autopsy. American Journal of Respiratory and Critical Care Medicine, 187, 761-767. [Google Scholar] [CrossRef] 
[31] Moret Iurilli, C., Brunetti, N., Di Corato, P., et al. (2018) Hy-peracute Hemodynamic Effects of BiPAP Noninvasive Ventilation in Patients with Acute Heart Failure and Left Ventric-ular Systolic Dysfunction in Emergency Department. Journal of Intensive Care Medicine, 33, 128-133. [Google Scholar] [CrossRef] [PubMed]
[32] Ezekowitz, J.A., Hu, J., Delgado, D., et al. (2012) Acute Heart Failure: Perspectives from a Randomized Trial and a Simultaneous Registry. Circulation: Heart Failure, 5, 735-741. [Google Scholar] [CrossRef] 
[33] Sharma, A., Hermann, D.D. and Mehta, R.L. (2001) Clinical Benefit and Approach of Ultrafiltration in Acute Heart Failure. Cardiology, 96, 144-154. [Google Scholar] [CrossRef] [PubMed]
[34] Umer, N., Makki, M., Kiran, S.K. and Jadoon, N.A. (2017) Serum Ferritin as a Predictor of 30 Days Mortality in Patients of Decompensated Chronic Liver Disease. Journal of Ayub Medical Col-lege Abbottabad, 29, 415-418.
[35] Briyal, S., Shah, S. and Gulati, A. (2014) Neuroprotective and Anti-Apoptotic Ef-fects of Liraglutide in the Rat Brain Following Focal Cerebral Ischemia. Neuroscience, 281, 269-281. [Google Scholar] [CrossRef] [PubMed]
[36] Demiselle, J., Besson, V., Sayegh, J.-F. and Augusto, J.-F. (2016) Total Artificial Heart and Chronic Haemodialysis: A Possible Bridge to Transplantation? Blood Purification, 42, 301-303. [Google Scholar] [CrossRef] [PubMed]
[37] Hall, J.L., Fermin, D.R., Birks, E.J., et al. (2011) Clinical, Molecular, and Genomic Changes in Response to a Left Ventricular Assist Device. Journal of the American College of Cardiology, 57, 641-652. [Google Scholar] [CrossRef] [PubMed]
[38] Undar, A. and Wang, S. (2013) Current Devices for Pediatric Ex-tracorporeal Life Support and Mechanical Circulatory Support Systems in the United States. Bio-Medical Materials and Engineering, 23, 57-62. [Google Scholar] [CrossRef] 
[39] Starling, R.C., Naka, Y., Boyle, A.J., et al. (2011) Results of the Post-U.S. Food and Drug Administration-Approval Study with a Continuous Flow Left Ventricular Assist Device as a Bridge to Heart Transplantation: A Prospective Study Using the INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support). Journal of the American College of Cardiology, 57, 1890-1898. [Google Scholar] [CrossRef] [PubMed]
[40] Lian, R., Zhang, G., Yan, S., et al. (2018) Role of Ultrasound Lung Comets in the Diagnosis of Acute Heart Failure in Emergency Department: A Systematic Review and Meta-Analysis. Biomedical and Environmental Sciences, 31, 596-607.
[41] Maciver, J. and Ross, H. (2012) Quality of Life and Left Ventricular Assist Device Support. Circulation, 126, 866-874. [Google Scholar] [CrossRef] 

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