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充血性心力衰竭

科研文章

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Age-Related Characteristics and Outcomes of Patients With Heart Failure With Preserved Ejection Fraction Nuclear Imaging of the Cardiac Sympathetic Nervous System: A Disease-Specific Interpretation in Heart Failure In acute HF and iron deficiency, IV ferric carboxymaltose reduced HF hospitalizations, but not CV death, at 1 y Natriuretic Peptide-Guided Heart Failure Therapy After the GUIDE-IT Study The pyruvate-lactate axis modulates cardiac hypertrophy and heart failure Heart Failure Outcomes With Volume-Guided Management Heart Failure and Atrial Fibrillation, Like Fire and Fury Percutaneous Atriotomy for Levoatrial–to–Coronary Sinus Shunting in Symptomatic Heart Failure: First-in-Human Experience Atrial Fibrillation and the Prognostic Performance of Biomarkers in Heart Failure SPECT and PET in ischemic heart failure

Review ArticleVolume 7, Issue 12, December 2019

JOURNAL:JACC: Heart Failure Article Link

Frailty Is Intertwined With Heart Failure: Mechanisms, Prevalence, Prognosis, Assessment, and Management

A Pandey, D Kitzman, G Reeves. Keywords: aging; frailty; Fried phenotype; heart failure; physical function; quality of life

ABSTRACT

Frailty, a syndrome characterized by an exaggerated decline in function and reserve of multiple physiological systems, is common in older patients with heart failure (HF) and is associated with worse clinical and patient-reported outcomes. Although several detailed assessment tools have been developed and validated in the geriatric population, they are cumbersome, not validated in patients with HF, and not commonly used in routine management of patients with HF. More recently, there has been an increasing interest in developing simple frailty screening tools that could efficiently and quickly identify frail patients with HF in routine clinical settings. As the burden and recognition of frailty in older patients with HF increase, a more comprehensive approach to management is needed that targets deficits across multiple domains, including physical function and medical, cognitive, and social domains. Such a multidomain approach is critical to address the unique, multidimensional challenges to the care of these high-risk patients and to improve their functional status, quality of life, and long-term clinical outcomes. This review discusses the burden of frailty, the conceptual underpinnings of frailty in older patients with HF, and potential strategies for the assessment, screening, and management of frailty in this vulnerable patient population.