Heart failure with preserved fjection fraction: overview and perioperative management

Falla cardiaca con fracción de eyección preservada: generalidades y aproximación en el perioperatorio;
Falência cardíaca com fração de ejeção preservada: generalidades e abordagens no perioperatório

dc.creatorLópez Garzón, Nelson Adolfo
dc.creatorÁngel, Gustavo Adolfo
dc.date2021-06-04
dc.date2023-03-22T19:09:44Z
dc.date2023-03-22T19:09:44Z
dc.date.accessioned2023-09-06T17:48:45Z
dc.date.available2023-09-06T17:48:45Z
dc.identifierhttps://revistas.unimilitar.edu.co/index.php/rmed/article/view/4854
dc.identifier10.18359/rmed.4854
dc.identifierhttp://hdl.handle.net/10654/43510
dc.identifier.urihttps://repositorioslatinoamericanos.uchile.cl/handle/2250/8692940
dc.descriptionHeart failure with preserved ejection fraction (HFPEF) is frequent and challenging to manage in the adult population during the perioperative period. It is a complex clinical syndrome with structural and functional cardiac abnormalities with left ventricular preserved ejection fraction (lvpef) > 50 %. Biomarkers, echocardiography, cardiac catheterization, and other noninvasive methods confirm the diagnosis. Currently, there is no specific effective management compared to failure with reduced LVPEF. Aim: to prepare a literature review of HFPEF and its anesthetic implications. Methods: a non-systematic literature review was carried out in the following databases: Pubmed/Medline, LILACS, ScienceDirect. Results: HFPEF is a common entity with a prevalence between 36.9 % and more than 50 % of all patients. The pathophysiology includes diastolic alterations of the cardiac cycle, including relaxation and ventricular compliance phases. From the anesthetic point of view, sinus rhythm should be maintained in arrhythmias, chronotropic response controlled, pulmonary congestion avoided, eti- ologies/comorbidities specifically managed, ventricular filling pressures preserved, and hemodynamic stability achieved. Conclusion: patients with hfpef represent an anesthetic challenge. Management includes specific treatment of etiologies, comorbidities, and phenotypes. Unlike heart failure with reduced ejection fraction, there are no therapies that reduce mortality, so new drugs and clinical studies are required to improve anesthetic prospects and therapeutic management.
dc.descriptionLa falla cardiaca con fracción de eyección preservada es frecuente y de difícil abordaje perioperatorio en población adulta. Es un síndrome clínico complejo con alteraciones estructurales y funcionales cardiacas con fracción de eyección del ventrículo izquierdo preservada (FEVI) > 50 %. Los biomarcadores, la ecocardiografía, el cateterismo cardiaco y otros métodos no invasivos confirman el diagnóstico. Actualmente no existe manejo específico efectivo comparado al de la falla con fevi reducida. Objetivo: elaborar una revisión de la literatura sobre la falla cardiaca con fracción de eyección preservada y sus implicaciones anestésicas. Métodos: se realizó una revisión no sistemática de la literatura en las siguientes bases de datos: Pubmed/Medline, LILACS, ScienceDirect. Resultados: la falla cardiaca con fracción de eyección preservada es una entidad común con una prevalencia entre 36,9 % y más del 50 % del total de pacientes. La fisiopatología incluye alteraciones diastólicas del ciclo cardiaco incluyendo las fases de relajación y de compliance ventricular. Desde el punto de vista anestésico se debe mantener el ritmo sinusal en arritmias, controlar la respuesta cronotrópica, evitar congestión pulmonar, manejar específicamente las etiologías-comorbilidades, conservar presiones de llenado ventricular y lograr estabilidad hemodinámica. Conclusión: los pacientes con este síndrome representan un reto anestésico. El manejo incluye tratamiento específico de las etiologías, comorbilidades y fenotipos. A diferencia de la falla cardiaca con fracción de eyección reducida, no existen terapias que disminuyan la mortalidad, por lo que se requieren nuevos fármacos y estudios clínicos que mejoren las perspectivas anestésicas y el abordaje terapéutico.
dc.descriptionA falência cardíaca de ejecção preservada é frequente e de difícil abordagem perioperatória na população adulta. É uma síndrome clínica complexa com alterações estruturais e funcionais cardíacas de ejeção do ventrículo esquerdo preservada (FEVI) > 50 %. Os biomarcadores, a ecocardiografia, o cateterismo cardíaco e outros métodos não invasivos confirmam o diagnóstico. Atualmente, não há manejo específico efetivo comparado à da falência com fevi reduzida. Objetivo: elaborar uma revisão da literatura sobre falência cardíaca com fração de ejeção preservada e suas implicações anestésicas. Métodos: foi realizada uma revisão não sistemática da literatura nas bases de dados: PubMed/Medline, LILACS, ScienceDirect. Resultados: a falência cardíaca com fração de ejeção preservada é uma entidade comum com uma prevalência entre 36,9 % e mais de 50 % do total de pacientes. A fisiopatologia inclui alterações diastólicas do ciclo cardíaco incluindo as fases de relaxamento e de complacência ventricular. Do ponto de vista anestésico, deve-se manter o ritmo sinusal em arritmias, controlar a resposta cronotrópica, evitar congestão pulmonar, lidar em específico com as etiologias-comorbidades, conservar pressões de fibrilação ventricular e atingir estabilidade hemodinâmica. Conclusão: os pacientes com essa síndrome representam um desafio anestésico. O manejo inclui tratamento específico das etiologias, comorbidades e fenótipos. À diferença da falência cardíaca com fração de ejeção reduzida, não existem terapias que diminuam a mortalidade; portanto, são exigidos novos fármacos e estudos clínicos que melhorem as perspectivas anestésicas e a abordagem terapêutica.
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dc.languagespa
dc.publisherUniversidad Militar Nueva Granada
dc.relationhttps://revistas.unimilitar.edu.co/index.php/rmed/article/view/4854/4627
dc.relationhttps://revistas.unimilitar.edu.co/index.php/rmed/article/view/4854/4783
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dc.rightsDerechos de autor 2021 Revista Med
dc.sourceRevista Med; Vol. 28 No. 2 (2020): july - december; 49-60
dc.sourceRevista Med; Vol. 28 Núm. 2 (2020): julio - diciembre; 49-60
dc.source1909-7700
dc.source0121-5256
dc.titleHeart failure with preserved fjection fraction: overview and perioperative management
dc.titleFalla cardiaca con fracción de eyección preservada: generalidades y aproximación en el perioperatorio
dc.titleFalência cardíaca com fração de ejeção preservada: generalidades e abordagens no perioperatório
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dc.typeinfo:eu-repo/semantics/publishedVersion


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