老年心力衰竭患者合并衰弱的最新研究进展

Research update on frailty combination in elderly patients with heart failure

衰弱作为一种常见的老年综合征,以多系统功能障碍为特点。心力衰竭是由各种心脏结构或功能性疾病导致心室充盈和(或)射血能力受损而引起的一组综合征,常常合并衰弱,与身体机能下降、跌倒、失能及认知倒退等相关。衰弱在老年心力衰竭患者中很常见,二者具有共同的机制特征,与炎症、肌肉减少症和高负担合并症等密切相关。衰弱与老年心力衰竭患者较差的临床表现、功能和生活质量有关,因此,开发简单、易操作并经过充分验证的评估工具识别衰弱至关重要。这些评估工具可以在常规临床环境中有效和快速地识别衰弱的心力衰竭患者,以便更好地改善临床预后。对于患有心力衰竭和衰弱的老年患者,应进一步研究新的治疗与管理策略,例如通过多学科评估和干预解决多系统疾病的模式,提高对心力衰竭合并衰弱的认识并加以管理,以期改善患者不良预后和提高其生活质量。

As a common geriatric syndrome,frailty is characterized by multiple system dysfunction.Heart failure(HF)is a group of syndromes caused by various structural or functional diseases of the heart,leading to impaired ventricular filling and/or blood ejection capacity,which often complicate with frailty and relate to decreased physical function,falls,disability,and cognitive decline.Frailty is common in older patients with heart failure,and both frailty and heart failure share common mechanistic features,including strong relations with a high burden of comorbidities,inflammation,and sarcopenia.Frailty is associated with worse clinical symptoms,organ function,and life quality in older patients with heart failure,so it is critical to develop simple,easy-to-use,and well-validated assessment tools to identify frailty.These assessment tools can efficiently and quickly identify frail patients with HF in routine clinical settings to better inform prognosis.In older patients with heart failure and frailty,novel management strategies,such as those addressing multiple domains through multidisciplinary assessment and intervention,should be investigated further.Raising awareness of the shared m echanism of HF with frailty and managing frailty may help improve quality of life and have a substantial impact on prognosis in HF patients.