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著者: Robert S McKelvie, Gordon W Moe, Anson Cheung, Jeannine Costigan, Anique Ducharme, Estrellita Estrella-Holder, Justin A Ezekowitz, John Floras, Nadia Giannetti, Adam Grzeslo, Karen Harkness, George A Heckman, Jonathan G Howlett, Simon Kouz, Kori Leblanc, Elizabeth Mann, Eileen O'Meara, Miroslav Rajda, Vivek Rao, Jessica Simon, Elizabeth Swiggum, Shelley Zieroth, J Malcolm O Arnold, Tom Ashton, Michel D'Astous, Paul Dorian, Haissam Haddad, Debra L Isaac, Marie-Hélène Leblanc, Peter Liu, Bruce Sussex, Heather J Ross
雑誌名: Can J Cardiol. 2011 May-Jun;27(3):319-38. doi: 10.1016/j.cjca.2011.03.011.
Abstract/Text
The 2011 Canadian Cardiovascular Society Heart Failure (HF) Guidelines Focused Update reviews the recently published clinical trials that will potentially impact on management. Also reviewed is the less studied but clinically important area of sleep apnea. Finally, patients with advanced HF represent a group of patients who pose major difficulties to clinicians. Advanced HF therefore is examined from the perspectives of HF complicated by renal failure, the role of palliative care, and the role of mechanical circulatory support (MCS). All of these topics are reviewed from a perspective of practical applications. Important new studies have demonstrated in less symptomatic HF patients that cardiac resynchronization therapy will be of benefit. As well, aldosterone receptor antagonists can be used with benefit in less symptomatic HF patients. The important role of palliative care and the need to address end-of-life issues in advanced HF are emphasized. Physicians need to be aware of the possibility of sleep apnea complicating the course of HF and the role of a sleep study for the proper assessment and management of the conditon. Patients with either acute severe or chronic advanced HF with otherwise good life expectancy should be referred to a cardiac centre capable of providing MCS. Furthermore, patients awaiting heart transplantation who deteriorate or are otherwise not likely to survive until a donor organ is found should be referred for MCS.
Copyright © 2011 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
PMID 21601772 Can J Cardiol. 2011 May-Jun;27(3):319-38. doi: 10.1016/j.cjca.2011.03.011.
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