心力衰竭的非药物治疗--从体育锻炼到电疗:文献综述。

A. Scarà, Z. Palamà, A. G. Robles, L. Dei, A. Borrelli, Federico Zanin, Leonardo Pignalosa, Silvio Romano, Luigi Sciarra
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引用次数: 0

摘要

心力衰竭(HF)是一项重大的全球性健康挑战,尽管药物治疗取得了进步,但其发病率和死亡率仍在不断上升。这篇综述探讨了非药物干预在心力衰竭管理中的有效性,研究了生活方式措施、体育锻炼和一些电疗法的作用,如导管消融、心脏再同步化疗法(CRT)和心脏收缩力调节(CCM)。结构化运动训练是这一领域的基石,在改善功能状态、提高生活质量和降低死亡风险方面效果显著,尤其是在射血分数降低的心房颤动(HFrEF)患者中。针对心房颤动、室性早搏和室性心动过速的导管消融可通过减轻心律失常负担来改善左心室功能。CRT 仍是对选定的高血压患者进行干预的关键手段,有助于实现左心室逆向重塑并改善症状。此外,CCM 这一新兴疗法为不符合 CRT 标准或无应答的患者提供了新的机会。将数字健康等非药物干预措施与特定药物相结合,是优化心房颤动治疗效果的关键。在这一多样化的患者群体中,必须根据不同患者的具体情况量身定制治疗方法,以实现效益最大化。有必要开展进一步的研究,以改进治疗策略,提高高血压患者的治疗效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Non-Pharmacological Treatment of Heart Failure-From Physical Activity to Electrical Therapies: A Literature Review.
Heart failure (HF) represents a significant global health challenge that is still responsible for increasing morbidity and mortality despite advancements in pharmacological treatments. This review investigates the effectiveness of non-pharmacological interventions in the management of HF, examining lifestyle measures, physical activity, and the role of some electrical therapies such as catheter ablation, cardiac resynchronization therapy (CRT), and cardiac contractility modulation (CCM). Structured exercise training is a cornerstone in this field, demonstrating terrific improvements in functional status, quality of life, and mortality risk reduction, particularly in patients with HF with reduced ejection fraction (HFrEF). Catheter ablation for atrial fibrillation, premature ventricular beats, and ventricular tachycardia aids in improving left ventricular function by reducing arrhythmic burden. CRT remains a key intervention for selected HF patients, helping achieve left ventricular reverse remodeling and improving symptoms. Additionally, the emerging therapy of CCM provides a novel opportunity for patients who do not meet CRT criteria or are non-responders. Integrating non-pharmacological interventions such as digital health alongside specific medications is key for optimizing outcomes in HF management. It is imperative to tailor approaches to individual patients in this diverse patient population to maximize benefits. Further research is warranted to improve treatment strategies and enhance patient outcomes in HF management.
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