精准医学在瓣膜性心脏病治疗中的应用。

IF 1.1 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
Herz Pub Date : 2025-04-01 Epub Date: 2025-03-04 DOI:10.1007/s00059-025-05299-w
Felix S Nettersheim, Stephan Baldus
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引用次数: 0

摘要

在过去的二十年中,由于导管治疗方法的出现,瓣膜性心脏病的治疗经历了显著的转变。直到21世纪初,对于许多被认为不适合进行常规手术的老年患者来说,药物治疗是唯一可用的治疗选择,而现在有了广泛的介入治疗。经导管主动脉瓣置换术和二尖瓣边缘修复术对于严重主动脉瓣狭窄和继发性二尖瓣返流的不能手术患者的预后明显优于药物治疗,并且在某些可手术患者组中,经导管主动脉瓣置换术和二尖瓣边缘修复术的疗效不低于常规手术。尽管基于导管的主动脉瓣和三尖瓣反流治疗尚未被证实可提供预后益处,但这些方法可显著和持续地改善症状和生活质量,同时显示出良好的安全性。鉴于治疗瓣膜性心脏病的多种选择,确定适当的适应症和选择最佳治疗方法往往构成重大挑战。本文综述了瓣膜性心脏病治疗的最新进展,并探讨了在精准医学的框架内以患者为中心的现有治疗方法的应用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Precision medicine in the management of valvular heart disease.

The management of valvular heart disease has undergone a remarkable transformation over the past two decades, which was driven by the advent of catheter-based treatment methods. Whereas medical therapy was the only available treatment option for many older patients deemed unsuitable for conventional surgery until the early 2000s, a wide range of interventional therapies is now available. Transcatheter aortic valve replacement and mitral valve transcatheter edge-to-edge repair evidently provide prognostic advantages over medical therapy for inoperable patients with severe aortic stenosis and secondary mitral regurgitation, and they have been demonstrated to be non-inferior to conventional surgery in certain operable patient groups. Although catheter-based therapies of aortic and tricuspid regurgitation have not yet been proven to provide prognostic benefits, these approaches enable substantial and sustainable improvements in symptoms as well as quality of life while demonstrating a favorable safety profile. Given the multitude of available options for the treatment of valvular heart diseases, determining the appropriate indication and selecting the optimal therapeutic approach often pose significant challenges. This review article highlights the latest advancements in valvular heart disease management and explores the patient-centered application of available therapies within the framework of an approach toward precision medicine.

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来源期刊
Herz
Herz 医学-心血管系统
CiteScore
3.00
自引率
5.90%
发文量
61
审稿时长
4-8 weeks
期刊介绍: Herz is the high-level journal for further education for all physicians interested in cardiology. The individual issues of the journal each deal with specific topics and comprise review articles in English and German written by competent and esteemed authors. They provide up-to-date and comprehensive information concerning the speciality dealt with in the issue. Due to the fact that all relevant aspects of the pertinent topic of an issue are considered, an overview of the current status and progress in cardiology is presented. Reviews and original articles round off the spectrum of information provided.
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