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[CHC2014]心力衰竭管理的现状和挑战 ——Mariell Jessup教授专访

作者:  MariellJessup   日期:2014/8/14 14:56:38

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心力衰竭是我们做得比较成功的一个领域,尤其是在挽救合并心肌梗死及心律失常的患者生命方面。

美国宾夕法尼亚大学医院Mariell Jessep教授

  International Circulation: I am joined today by Dr. Mariell Jessup, she has spent what has probably been an exciting year as the President of the American Heart Association and we welcome you here Dr. Jessup.

  《国际循环》:非常高兴今天能采访到AHA前任主席Mariell Jessup教授。

  Dr. Jessup: Thank you.

  Jessup教授:谢谢。

  International Circulation: Thank you for spending time with us today.

  《国际循环》:感谢您今天拨冗接受我们的采访。

  Dr. Jessup: It is my pleasure to be here today.

  Jessup教授:我非常高兴在这里接受采访。

  International Circulation: With this year’s CHC, the title of your plenary session was “Heart Failure: State of the ART and Challenge”. If you would give us maybe

  《国际循环》:在今年的CHC上,您作了题为“心力衰竭的现状与挑战”专题讲座。您认为就这一问题我们应了解哪些内容?

  Dr. Jessup: I talked about all of the progress that we have made in the treatment of heart failure. Heart failure is a story of our success in other issues, in particular in saving patient’s lives with myocardial infarctions and arrhythmias. Patients now live but they live with heart failure, plus we are seeing more heart failure because our populations are getting more elderly. They are living longer but since heart failure is a disease of the elderly we are seeing more heart failure. If we divide heart failure into those patients who have a low ejection fraction, HFrEF, then we have lots of treatments. We have had good treatments that make people feel better and live longer and we have had these for a long time. In fact we are waiting for a new drug that actually may be working differently than the drugs we’ve used before. But if we talk about the other group of patients with heart failure, HFpEF, or heart failure with preserved ejection fraction, we are very frustrated because there has been a number of trials now but yet we have not found anything that definitively makes people feel better and live longer. We have new knowledge about inherited disorders and inherited cardiac muscle disorders that cause heart failure but I think that compels us to begin a much better job at screening patients and understanding the genetics. Finally we are seeing a new population of patients with heart failure, patients that have heart failure because they have had cancer chemotherapy. That kind of heart failure can have its onset five or ten or even 15 years after patients underwent chemotherapy. There is a lot of good news and a lot of challenges that face us.

  Jessup教授:在讲座中,我介绍了我们在心力衰竭治疗领域所取得的进展。其实,心力衰竭是我们做得比较成功的一个领域,尤其是在挽救合并心肌梗死及心律失常的患者生命方面。随着人口老龄化加剧,心力衰竭患者越来越多,而现在我们已经可以做到让患者带病(心力衰竭)生活。鉴于心力衰竭是一种老年病,其发病率逐渐增加,但患者的生存期却更长。心力衰竭可分为射血分数降低的心力衰竭(HFrEF)与射血分数保留的心力衰竭(HFpEF)。就HFrEF而言,我们早就有很多很好的治疗方法,可以让患者感觉更好、活得更长。我们希望能研发出作用机制不同于现在所用药物的新药。但就HFpEF而言,相关研究及治疗并不乐观。因为到目前为止,大量试验并未发现能明确改善患者症状及生存期的有效措施。虽然我们对遗传性疾病及遗传性心肌病有了新认识,但我认为我们还需在如何筛选患者及理解心力衰竭发病的遗传学机制方面开展更好的工作。最后,我们发现有一群新的特殊心力衰竭患者,因接受癌症化疗而出现心力衰竭。这种心力衰竭可在患者接受化疗5年、10年甚至15年之后才发生。总之,在心力衰竭领域我们取得了一些进展,但同时也仍面临很多挑战。

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心力衰竭射血分数 HFrEF HFpEF

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