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首页> 外文期刊>The Journal of cardiovascular nursing >Key Clinical Insights From the Sudden Cardiac Death in Heart Failure Trial
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Key Clinical Insights From the Sudden Cardiac Death in Heart Failure Trial

机译:心力衰竭试验中突然心脏死亡的重要临床见解

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Heart failure (HF) is a common and lethal syndrome. Those with moderate left ventricular dysfunction have a substantial risk of premature and sudden death, approximately 25% over 2.5 years. Fifty percent of these deaths are thought to be sudden due to dysrhythmias, which may be preventable. As a consequence, patients with HF represent the largest, single identifiable population of patients that can be targeted for primary prevention of sudden cardiac death. A trial known as SCD-HeFT (The Sudden Cardiac Death in Heart Failure Trial), sponsored by the National Heart Lung and Blood Institute of the National Institutes of Health, was designed to evaluate the value of the prophylactic amiodarone or implantabie cardioverter defibrillator therapy in patients with HF. This article reviews 4 key clinical insights highlighted by the SCD-HeFT results: (1) ramifications of implantabie cardioverter defibrillator use in patients with New York Heart Association (NYHA) class II HF; (2) the value or lack thereof of implantabie cardioverter defibriliator therapy in patients with NYHA class III HF; (3) the danger of amiodarone drug therapy in patients with NYHA class III HF; and (4) the significant value of basic medical management, when well implemented, in prolonging life in this population. In addition, future directions in the evaluation and management of patients with moderate to severe HF are addressed.
机译:心力衰竭(HF)是一种常见且致命的综合征。患有中度左心功能不全的人有过早死亡和猝死的风险,在2.5年内约占25%。这些死亡的百分之五十被认为是由于心律不齐而突然发生的,这是可以预防的。结果,HF患者代表了可用于一级预防心源性猝死的最大,唯一可识别患者群体。由美国国立卫生研究院国家心肺和血液研究所赞助的一项名为SCD-HeFT(心力衰竭猝死的试验)的试验旨在评估预防性胺碘酮或植入式心脏复律除颤器治疗的价值。 HF患者。本文回顾了SCD-HeFT结果突出的4个关键临床见解:(1)在纽约心脏协会(NYHA)II类HF患者中使用植入式心脏复律除颤器的后果; (2)植入性心脏复律除颤剂治疗在NYHA III级HF患者中的价值或缺乏价值; (3)胺碘酮药物治疗对NYHA III级HF患者的危险性; (4)如果实施得当,基本医疗管理对于延长该人群的寿命具有重大价值。此外,还讨论了中重度HF患者评估和治疗的未来方向。

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