Abstract:
Although acute heart failure (AHF) is a common disease associated with significant symptoms, morbidity and mortality, the diagnosis, risk stratification and treatment of patients with hypertensive acute heart failure (H-AHF) still remain a challenge in modern medicine. Despite great progress in diagnostic and therapeutic modalities, this disease is still accompanied by a high rate of both in-hospital (from 3.8% to 11%) and one-year (from 20% to 36%) mortality. Considering the high rate of rehospitalization (22% to 30% in the first three months), the treatment of this disease represents a major financial blow to the health system of each country. This disease is characterized by heterogeneity in precipitating factors, clinical presentation, therapeutic modalities and prognosis. Since heart decompensation usually occurs quickly (within a few hours) in patients with H-AHF, establishing a rapid diagnosis is of vital importance. In addition to establishing the diagnosis of heart failure itself, it is necessary to see the underlying cause that led to it, especially if it is de novo heart failure. Given that hypertension is a precipitating factor of AHF and in up to 11% of AHF patients, strict control of arterial blood pressure is necessary until target values are reached in order to prevent the occurrence of H-AHF, which is still accompanied by a high rate of both early and long-term mortality.
摘要:
虽然急性心力衰竭(AHF)是一种常见的疾病与显著的症状相关,发病率和死亡率,诊断,高血压急性心力衰竭(H-AHF)患者的危险分层和治疗在现代医学中仍然是一个挑战.尽管在诊断和治疗方式方面取得了很大进展,这种疾病仍然伴随着很高的住院死亡率(从3.8%到11%)和一年死亡率(从20%到36%).考虑到再住院率很高(前三个月为22%至30%),这种疾病的治疗是对每个国家卫生系统的重大财政打击。这种疾病的特点是在诱发因素的异质性,临床表现,治疗方式和预后。由于H-AHF患者的心脏代偿失调通常发生得很快(在几个小时内),建立快速诊断至关重要。除了建立心力衰竭本身的诊断,有必要看到导致它的根本原因,特别是如果是新的心力衰竭。鉴于高血压是AHF的诱发因素,并且在高达11%的AHF患者中,必须严格控制动脉血压,直到达到目标值,以防止H-AHF的发生,这仍然伴随着较高的早期和长期死亡率。