心率-血压双靶点管理对射血分数下降型心力衰竭预后的影响:机制、证据与临床实践OA
Impact of dual-target management of heart rate and blood pressure on the prognosis of heart failure with reduced ejection fraction:mechanism,evidence,and clinical practice
心率与血压调控是射血分数下降型心力衰竭(HFrEF)预后改善的核心靶点,但其双靶点协同管理的机制与策略仍需系统阐明.本文系统梳理近10年相关研究,整合PubMed、CNKI等数据库的病理生理机制研究、随机对照试验(RCT)及真实世界数据,重点阐述双靶点管理对HFrEF预后的影响.研究证实,HFrEF患者静息心率＞70次/min或收缩压(SBP)＜110 mmHg(或＞140 mmHg)均显著增加死亡风险,动态监测联合生物标志物可优化治疗目标,早期联用β受体阻滞剂与伊伐布雷定能加速心率达标.综上,突破"一刀切"管理模式,建立基于血流动力学与分子标志物的个体化策略,是未来改善HFrEF患者预后的关键方向.
Heart rate and blood pressure are established therapeutic targets for prognostic improvement in heart failure with reduced ejection fraction(HFrEF);however,the mechanisms and strategies for their synergistic management remain to be fully eluci-dated.This review synthesizes evidence from the past 10 years,integrates pathophysiological mechanism studies,randomized controlled trials(RCTs),and real-world data from databases such as PubMed and CNKI,and focuses on the impact of dual target management on the prognosis of HFrEF.Research has confirmed that resting heart rate＞70 beats/min or systolic blood pressure(SBP)＜110 mmHg(or＞140 mmHg)in HFrEF patients significantly increases the risk of mortality.Dynamic monitoring combined with biomarkers can optimize treatment goals,and early use of beta blockers and ivabradine can accelerate heart rate to reach the target.In conclusion,breaking through the"one-size-fits-all"management model and establishing individualized strategies based on hemodynamics and molecular biomarkers are the key directions for improving the prognosis of HFrEF patients in the future.
谭玉燕;冉玉柳;刘燕
右江民族医学院研究生学院,广西百色 533000右江民族医学院研究生学院,广西百色 533000右江民族医学院附属医院心血管内科重症监护病区,广西百色 533000
医药卫生
射血分数下降型心衰心率血压
heart failure with reduced ejection fraction(HFrEF)heart rateblood pressure
《右江医学》 2026 (5)
417-422,6
广西自然科学基金(2024JJH140107)
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