摘要
心衰(HF)患者的住院率和生存率已得到改善。然而,5年死亡率仍然很高,而且由于人口老龄化和其他急性和慢性心血管疾病的诊断和治疗进展,该病的患病率正在上升。在过去的三十年中,随着针对神经激素激活的药物和防止心源性猝死和改善心脏同步的装置的发展,心力衰竭的治疗设备有了实质性的改善。近年来,抑制血管紧张素受体和新溶血素以及调节f电流的窦房起搏器被发现是提高HF住院率和/或死亡率的安全有效的策略。抗糖尿病药物抑制钠-葡萄糖协同转运体2,导致利钠和渗透性利尿,并可能进一步改善HF的相关结果。此外,心肌肌球蛋白激活剂、可溶性冠苷酸环化酶刺激剂和非甾体类矿皮质激素受体拮抗剂等新兴疗法正在心力衰竭患者的II期和III期研究中接受研究。最后,随着第二代和第三代连续血流左心室辅助装置在临床实践中的应用,先进心衰的治疗得到了迅速发展。正在进行的临床研究将验证新出现的治疗策略在以往临床试验中缺乏代表性的HF人群中的安全性和有效性。
关键词: 心衰(HF),尼泊尔碱抑制剂,ivabradin,左心室辅助装置,新的治疗策略,窦房起搏。
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