Interpretation on Chinese Guidelines for the Diagnosis and Treatment of Heart Failure 2024
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摘要:
近年来, 心力衰竭(下文简称"心衰")的治疗特别是药物治疗取得了突破性进展, 慢性心衰的分类、心衰及其合并症的治疗方案等也在不断更新。为进一步提升我国心衰的诊疗水平, 中华医学会心血管病学分会、中国医师协会心血管内科医师分会、中国医师协会心力衰竭专业委员会、中华心血管病杂志编辑委员会联合制定了《中国心力衰竭诊断和治疗指南2024》, 该指南在心衰分类与分期、评估与诊断、治疗以及中国证据等方面进行了重要更新和优化, 为心衰诊断和治疗提供了更为全面、精细的指导。本文将对指南的主要推荐内容进行解读, 以便读者能够更好地理解和掌握其核心内容。
Abstract:In the past few years, there have been many breakthroughs in the treatment of heart failure, especially in drug therapy. The classification of chronic heart failure and treatment methods for heart failure and its complications are also constantly updated. In order to apply these achievements to a better diagnosis and treatment of heart failure patients in China, Chinese Society of Cardiology, Chinese Medical Association, Chinese College of Cardiovascular Physician, Chinese Heart Failure Association of Chinese Medical Doctor Association, Editorial Board of Chinese Journal of Cardiology have jointly published the Chinese Guidelines for the Diagnosis and Treatment of Heart Failure 2024, which comprehensively updates the new consensus and evidence-based treatment in the field of heart failure. These contents are of great significance for guiding diagnosis and treatment of heart failure patients in clinical practice. This article, therefore, aims to interpret the main updated contents and key points to provide readers with a better understanding of its key information.
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Keywords:
- heart failure /
- diagnosis /
- treatment /
- guidelines /
- interpretation
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本刊执行GB/T 15835-2011《出版物上数字用法》中有关数字的规定及其书写规则,对参数与偏差范围的表示的要求如下。(1)数值的范围:一般使用浪纹连接号“~”。例如:5至10可写成5~10;但5万至10万应写成5万~10万,不能写成5~10万。(2)幂次相同的参数范围:前一个参数的幂次不能省略。例如:3×109~5×109不能写成3~5×109,但可以写成(3~5) ×109。(3)百分数范围:前一个参数的百分号不能省略。例如:20%~30%不能写成20~30%。(4)单位相同的参数范围:只需写出后一个参数的单位。例如:15~20 ℃不必写成15 ℃~25 ℃,但不能写成15°~25 ℃。(5)单位不完全相同的参数范围:每个参数的单位必须全部写出。例如:36°~42°18′。(6)偏差范围:参数与其偏差单位相同时,单位可以只写1次,并应加圆括号将数值组合,置共同的单位符号于全部数值之后。例如:(15.2 ± 0.2) mm。表示带中心值的百分数偏差时,可以写成(27±2)%,也可以写成27%±2%,而不应写成27±2%。
作者贡献:田庄负责撰写指南及解读;张抒扬负责构建指南重要框架和内容。利益冲突:所有作者均声明不存在利益冲突 -
[1] 中华医学会心血管病学分会心力衰竭学组, 中国医师协会心力衰竭专业委员会, 中华心血管病杂志编辑委员会. 中国心力衰竭诊断和治疗指南2018[J]. 中华心血管病杂志, 2018, 46(10): 760-789. DOI: 10.3760/cma.j.issn.0253-3758.2018.10.004 Heart Failure Group of Chinese Society of Cardiology of Chinese Medical Association, Chinese Heart Failure Association of Chinese Medical Doctor Association, Editorial Board of Chinese Journal of Cardiology. Chinese guidelines for the diagnosis and treatment of heart failure 2018[J]. Chin J Cardiol, 2018, 46(10): 760-789. DOI: 10.3760/cma.j.issn.0253-3758.2018.10.004
[2] 中华医学会心血管病学分会, 中国医师协会心血管内科医师分会, 中国医师协会心力衰竭专业委员会, 等. 中国心力衰竭诊断和治疗指南2024[J]. 中华心血管病杂志, 2024, 52(3): 235-275. https://www.cnki.com.cn/Article/CJFDTOTAL-XHYX202404009.htm Chinese Society of Cardiology, Chinese Medical Association, Chinese College of Cardiovascular Physician, Chinese Heart Failure Association of Chinese Medical Doctor Association, et al. Chinese guidelines for the diagnosis and treatment of heart failure 2024[J]. Chin J Cardiol, 2024, 52(3): 235-275. https://www.cnki.com.cn/Article/CJFDTOTAL-XHYX202404009.htm
[3] Halliday B P, Wassall R, Lota A S, et al. Withdrawal of pharmacological treatment for heart failure in patients with recovered dilated cardiomyopathy(TRED-HF): an open-label, pilot, randomised trial[J]. Lancet, 2019, 393(10166): 61-73. DOI: 10.1016/S0140-6736(18)32484-X
[4] McMurray J J V, Solomon S D, Inzucchi S E, et al. Dapagliflozin in patients with heart failure and reduced ejection fraction[J]. N Engl J Med, 2019, 381(21): 1995-2008. DOI: 10.1056/NEJMoa1911303
[5] Packer M, Anker S D, Butler J, et al. Cardiovascular and renal outcomes with empagliflozin in heart failure[J]. N Engl J Med, 2020, 383(15): 1413-1424. DOI: 10.1056/NEJMoa2022190
[6] Armstrong P W, Pieske B, Anstrom K J, et al. Vericiguat in patients with heart failure and reduced ejection fraction[J]. N Engl J Med, 2020, 382(20): 1883-1893. DOI: 10.1056/NEJMoa1915928
[7] McDonagh T A, Metra M, Adamo M, et al. 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure[J]. Eur J Heart Fail, 2022, 24(1): 3599-3726.
[8] Heidenreich P A, Bozkurt B, Aguilar D, et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines[J]. Circulation, 2022, 145(18): e895-e1032.
[9] McMurray J J V, Packer M. How should we sequence the treatments for heart failure and a reduced ejection fraction?: A redefinition of evidence-based medicine[J]. Circulation, 2021, 143(9): 875-877. DOI: 10.1161/CIRCULATIONAHA.120.052926
[10] Hulot J S, Trochu J N, Donal E, et al. Vericiguat for the treatment of heart failure: mechanism of action and pharmacological properties compared with other emerging thera-peutic options[J]. Expert Opin Pharmacother, 2021, 22(14): 1847-1855. DOI: 10.1080/14656566.2021.1937121
[11] Greene S J, Ezekowitz J A, Anstrom K J, et al. Medical therapy during hospitalization for heart failure with reduced ejection fraction: the VICTORIA registry[J]. J Card Fail, 2022, 28(7): 1063-1077. DOI: 10.1016/j.cardfail.2022.02.011
[12] Anker S D, Butler J, Filippatos G, et al. Empagliflozin in heart failure with a preserved ejection fraction[J]. N Engl J Med, 2021, 385(16): 1451-1461. DOI: 10.1056/NEJMoa2107038
[13] Solomon S D, McMurray J J V, Claggett B, et al. Dapagliflozin in heart failure with mildly reduced or preserved ejection fraction[J]. N Engl J Med, 2022, 387(12): 1089-1098. DOI: 10.1056/NEJMoa2206286
[14] 中华医学会心血管病学分会, 中国生物医学工程学会心律分会. 心房颤动诊断和治疗中国指南[J]. 中华心血管病杂志, 2023, 51(6): 572-618. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXYX202310002.htm Chinese Society of Cardiology, Chinese Medical Association, Heart Rhythm Committee of Chinese Society of Biomedical Engineering. Chinese guidelines on diagnosis and manage-ment of atrial fibrillation[J]. Chin J Cardiol, 2023, 51(6): 572-618. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXYX202310002.htm
[15] Sohns C, Fox H, Marrouche N F, et al. Catheter ablation in end-stage heart failure with atrial fibrillation[J]. N Engl J Med, 2023, 389(15): 1380-1389.
[16] Ponikowski P, Kirwan B A, Anker S D, et al. Ferric carboxymaltose for iron deficiency at discharge after acute heart failure: a multicentre, double-blind, randomised, controlled trial[J]. Lancet, 2020, 396(10266): 1895-1904.
[17] Kalra P R, Cleland J G F, Petrie M C, et al. Intravenous ferric derisomaltose in patients with heart failure and iron deficiency in the UK(IRONMAN): an investigator-initiated, prospective, randomised, open-label, blinded-endpoint trial[J]. Lancet, 2022, 400(10369): 2199-2209.
[18] Anker S D, Khan M S, Butler J, et al. Effect of intravenous iron replacement on recurrent heart failure hospitalizations and cardiovascular mortality in patients with heart failure and iron deficiency: a Bayesian meta-analysis[J]. Eur J Heart Fail, 2023, 25(7): 1080-1090.
[19] McDonagh T A, Metra M, Adamo M, et al. 2023 Focused update of the 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure[J]. Eur Heart J, 2023, 44(37): 3627-3639.
[20] Mentz R J, Garg J, Rockhold F W, et al. Ferric carboxymaltose in heart failure with iron deficiency[J]. N Engl J Med, 2023, 389(11): 975-986.
[21] Garcia-Pavia P, Rapezzi C, Adler Y, et al. Diagnosis and treatment of cardiac amyloidosis. A position statement of the European Society of Cardiology Working Group on Myocar-dial and Pericardial Diseases[J]. Eur J Heart Fail, 2021, 23(4): 512-526.
[22] 田庄, 张抒扬. 《转甲状腺素蛋白心脏淀粉样变诊断与治疗中国专家共识》解读及诊断路径更新[J]. 罕见病研究, 2023, 2(1): 63-69. https://www.cnki.com.cn/Article/CJFDTOTAL-HJBI202301009.htm Tian Z, Zhang S Y. The interpretation and update of the diagnosis pathway of Chinese expert consensus on the diagnosis and treatment of transthyretin cardiac amyoidosis[J]. J Rare Dis, 2023, 2(1): 63-69. https://www.cnki.com.cn/Article/CJFDTOTAL-HJBI202301009.htm
[23] Maurer M S, Schwartz J H, Gundapaneni B, et al. Tafamidis treatment for patients with transthyretin amyloid cardiomyopathy[J]. N Engl J Med, 2018, 379(11): 1007-1016.
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