心房内分流术治疗慢性心力衰竭的进展

Treatment of Chronic Heart Failure by Inter-atrial Shunt

尽管抗心力衰竭药物治疗和器械治疗有了长足的发展,但射血分数降低的心力衰竭或射血分数保留的心力衰竭发病率和死亡率仍居高不下。即使经过充分的抗心力衰竭药物治疗,仍有近50%的心力衰竭患者临床心功能得不到明显改善。射血分数保留的心力衰竭临床特征是劳力性呼吸困难,通常在运动时左心房压力异常升高所致。人为建立心房内分流减轻左心房负荷可能是一种新的治疗方法。现将心房内分流术治疗慢性心力衰竭尤其是射血分数保留的心力衰竭的最新进展进行综述。

Despite considerable advances in anti-heart failure drug and device therapy,the morbidity and mortality of heart failure with reduced ejection fraction or heart failure with preserved ejection fraction remained high.Even after adequate anti-heart failure treatment,nearly 50% of patients with heart failure still have no significant improvement in clinical cardiac function.The clinical hallmark of heart failure with preserved ejection fraction is exertional breathlessness,usually due to abnormal increase in left atrial pressure during exercise.Artificial inter-atrial shunt to relieve left atrial load may be a new therapy.This article reviews the recent progress of inter-atrial shunt in the treatment of chronic heart failure,especially heart failure with preserved ejection fraction.