心不全診療Controversy

出版社： 中外医学社
著者：
発行日： 2023-10-10
分野： 臨床医学：内科  >  循環器一般
ISBN： 9784498136809
電子書籍版： 2023-10-10 （1版1刷）
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心臓以外の併存症のある患者の対応や，ADLや症状の改善を一番に考える場合など，心不全の診療ガイドラインを当てはめるだけでは対応できないような臨床の実際に対応するために，臨床のさじ加減をエキスパートが伝授！最新のエビデンスに診療経験を融合させた「思考プロセス」が見える1冊．

目次

  • 薬物療法のControversy
    　1　HFrEFに対するガイドライン推奨薬はどの順番でどのくらい期間をかけてtitrationを完了すべきか？
    　2　HFrEFに対するガイドライン推奨薬は何をゴールにしてtitrationを完了すべきか？
    　3　心不全に対するARNIは，1回投与ではなくやはり2回投与がよいのか？
    　4　SGLT2阻害薬はどのような心不全に特に有効か？　そもそもなぜ効くのか？
    　5　低栄養・サルコペニア・フレイル合併例にSGLT2阻害薬を投与してよいのか？
    　6　HFrEFにおいて収縮期血圧が90 mmHg未満の場合，ガイドライン推奨薬は継続すべきか？
    　7　高度腎機能障害（CKDステージ4〜5）を有するHFrEFに有効な薬剤は存在するか？
    　8　HFrEFに高カリウム血症を伴った場合にACE阻害薬/ARB，ARNI，MRAは減量すべきか？
    　9　Cpc-PHに対するベルイシグアトは有効か？
    　10　HFimpEFでGDMTは生涯継続すべきか？
    　11　高齢者の心不全は非高齢者の心不全と同様の薬物治療を行ってよいのか？
    　12　心臓サルコイドーシスでステロイドはどこまで減量するべきか，
    　　　　定期的な活動性評価でPET検査は必要か，バイオマーカーでもよいか？
    　13　閉塞性肥大型心筋症に対してジソピラミド・シベンゾリンを使うのか，
    　　　　マバカムテンはどのような扱いになるのか？
    　
    デバイスのControversy
    　14　ICD一次予防の適応はガイドラインに従ってLVEFで判断してよいか？
    　15　着用型自動除細動器（WCD）は一次予防でどう使う？
    　16　徐脈性不整脈に対し刺激伝導系ペーシングの適応を検討すべきか？
    　17　心不全でもASVを使用してもよい病態はあるのか？
    　18　Destination therapyは積極的に進めるべきか？
    　
    カテーテル・外科的治療のControversy
    　19　心房細動を伴った心不全では，LVEFを問わずカテーテルアブレーションを積極的に実施すべきか？
    　20　慢性冠症候群を伴ったHFrEFにおける適切な治療戦略は？
    　21　負荷エコーでMitraClipの適応判断の根拠はどこまで証明されてきたか？
    　22　大動脈弁狭窄症に対するカテーテル治療後の心不全予防のための薬物治療戦略は？
    　23　低侵襲カテーテル時代の三尖弁閉鎖不全症に対する適切な介入時期・方法は？
    　
    疾病管理・緩和のControversy
    　24　塩分制限・水分制限は絶対に守らないといけないのか？
    　25　包括的な疾病管理プログラムを一律に提供しているだけでよいのか？
    　26　自宅で有効な心臓リハビリテーションは実施できないのか？
    　27　Advance Care Planningの効果はどこまで証明されているのか？
    　28　洞調律心不全患者での抗凝固療法は必要か？
    　29　貧血合併心不全患者はどのようにマネージメントすればよいのか？
    　
    急性心不全のControversy
    　30　急性心不全患者に，door-to-furosemide timeは有効？
    　31　急性期の血管拡張薬はどう使用するのが一番よいのか？
    　32　心原性ショックに対する薬物治療は，何を選択するのか　
    　　　（ノルアドレナリン，ドブタミン，はたまたドパミン）？
    　33　心原性ショックに対する補助循環は，何を選択するのか（IABP vs Impella）？
    　34　ループ利尿薬は，何を・どのくらい・どうやって投与するのが正しいのか？
    　35　利尿薬抵抗性に対する治療戦略は？〈秋山英一〉
    　36　利尿薬投与中にクレアチニンが上昇した場合，どこまで様子をみてよいのか？
    　37　急性心不全の呼吸補助にnasal high flowは使えるか，コロナ禍を考えても使う意義は？
    　38　入院中・早期から心拍コントロールのためイバブラジン投与をしてよいか？
    　39　入院中・早期からのARNIはよいのか？ 血行動態的に有利なのか？
    　
    その他のControversy
    　40　HFpEFの治療選択に対してフェノタイピングは必要か？その場合，実臨床で現実的な評価方法は？
    　41　がん治療薬関連心筋障害の早期発見はどうすればできるのか？
    　42　心不全患者のQOL・身体活動評価はまだNYHA分類で考えていてよいのか，
    　　　　PROやデジタルデバイスはどう考えるのか？
    　43　心不全の治療（効果）には人種差があるのか？

この書籍の参考文献

参考文献のリンクは、リンク先の都合等により正しく表示されない場合がありますので、あらかじめご了承下さい。

本参考文献は電子書籍掲載内容を元にしております。

薬物療法のControversy

P.5 掲載の参考文献
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9) Packer M, et al ; EMPEROR-Reduced Trial Investigators. Cardiovascular and renal outcomes with empagliflozin in heart failure. N Engl J Med. 2020 ; 383 : 1413-24.
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13) Willenheimer R, et al ; CIBIS III Investigators. Effect on survival and hospitalization of initiating treatment for chronic heart failure with bisoprolol followed by enalapril, as compared with the opposite sequence : results of the randomized Cardiac Insufficiency Bisoprolol Study (CIBIS) III. Circulation. 2005 ; 112 : 2426-35.
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15) Vardeny O, et al ; Prospective Comparison of ARNI with ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure (PARADIGM-HF) Investigators. Efficacy of sacubitril/valsartan vs. enalapril at lower than target doses in heart failure with reduced ejection fraction : the PARADIGM-HF trial. Eur J Heart Fail. 2016 ; 18 : 1228-34.
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17) Packer M, et al. Effect of empagliflozin on the clinical stability of patients with heart failure and a reduced ejection fraction : The EMPEROR-Reduced Trial. Circulation. 2021 ; 143 : 326-36.
 
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19) Packer M, et al. Rapid evidence-based sequencing of foundational drugs for heart failure and a reduced ejection fraction. Eur J Heart Fail. 2021 ; 23 : 882-94.
 
20) McAlister FA, et al. Meta-analysis : beta-blocker dose, heart rate reduction, and death in patients with heart failure. Ann Intern Med. 2009 ; 150 : 784-94.
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21) Hori M, et al ; MUCHA Investigators. Low-dose carvedilol improves left ventricular function and reduces cardiovascular hospitalization in Japanese patients with chronic heart failure : the Multicenter Carvedilol Heart Failure Dose Assessment (MUCHA) trial. Am Heart J. 2004 ; 147 : 324-30.
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22) Mebazaa A, et al. Safety, tolerability and efficacy of up-titration of guideline-directed medical therapies for acute heart failure (STRONG-HF) : a multinational, open-label, randomised, trial. Lancet. 2022 ; 400 : 1938-52.
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23) Aimo A, et al. Imaging, biomarker, and clinical predictors of cardiac remodeling in heart failure with reduced ejection fraction. JACC Heart Fail. 2019 ; 7 : 782-94.
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24) Greene SJ, et al. Contextualizing risk among patients with heart failure. JAMA. 2021 ; 326 : 2261-2.
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P.13 掲載の参考文献
1) Heidenreich PA, et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure : a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022 ; 145 : e895-e1032.
 
2) McDonagh TA, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021 ; 42 : 3599-726.
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3) Savage HO, et al. Sequencing of medical therapy in heart failure with a reduced ejection fraction. Heart. 2023 ; 109 : 511-8.
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4) Bhatt AS, et al. Treatment of HF in an era of multiple therapies : statement from the HF collaboratory. JACC Heart Fail. 2021 ; 9 : 1-12.
 
5) Miller RJH, et al. A novel approach to medical management of heart failure with reduced ejection fraction. Can J Cardiol. 2021 ; 37 : 632-43.
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6) Fiuzat M, et al. Assessment of limitations to optimization of guideline-directed medical therapy in heart failure from the GUIDE-IT trial : a secondary analysis of a randomized clinical trial. JAMA Cardiol. 2020 ; 5 : 757-64.
 
7) Komajda M, et al. Physicians' guideline adherence is associated with better prognosis in outpatients with heart failure with reduced ejection fraction : the QUALIFY international registry. Eur J Heart Fail. 2017 ; 19 : 1414-23.
 
8) Savarese G, et al. Heart failure drug treatment-inertia, titration, and discontinuation : a multinational observational Study (EVOLUTION HF). JACC Heart Fail. 2023 ; 11 : 1-14.
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9) Greene SJ, et al. Clinical inertia and medical therapy for heart failure : the unintended harms of 'first, do no harm'. Eur J Heart Fail. 2021 ; 23 : 1343-5.
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10) Bhandari S, et al. Renin-angiotensin system inhibition in advanced chronic kidney disease. N Engl J Med. 2022 ; 387 : 2021-32.
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12) Mebazaa A, et al. Safety, tolerability and efficacy of up-titration of guideline-directed medical therapies for acute heart failure (STRONG-HF) : a multinational, open-label, randomised, trial. Lancet. 2022 ; 400 : 1938-52.
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13) Greene SJ, et al. Titration of medical therapy for heart failure with reduced ejection fraction. J Am Coll Cardiol. 2019 ; 73 : 2365-83.
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14) Peri-Okonny PA, et al. Target doses of heart failure medical therapy and blood pressure : insights from the CHAMP-HF registry. JACC Heart Fail. 2019 ; 7 : 350-8.
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19) Bayes-Genis A, et al. Omics phenotyping in heart failure : the next frontier. Eur Heart J. 2020 ; 41 : 3477-84.
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P.19 掲載の参考文献
1) Dargad RR, et al. Sacubitril/valsartan : a novel angiotensin receptor-neprilysin inhibitor. Indian Heart J. 2018 ; 70 : S102-10.
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2) Murphy SP, et al. Atrial natriuretic peptide and treatment with sacubitril/valsartan in heart failure with reduced ejection fraction. JACC Heart Fail. 2021 ; 9 : 127-36.
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3) Kimura K, et al. ANP is cleared much faster than BNP in patients with congestive heart failure. Eur J Clin Pharmacol. 2007 ; 63 : 699-702.
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5) Gu J, et al. Pharmacokinetics and pharmacodynamics of LCZ696, a novel dual-acting angiotensin receptor-neprilysin inhibitor (ARNi). J Clin Pharmacol. 2010 ; 50 : 401-14.
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6) Packer M, et al. Comparison of omapatrilat and enalapril in patients with chronic heart failure : the Omapatrilat Versus Enalapril Randomized Trial of Utility in Reducing Events (OVERTURE). Circulation. 2002 ; 106 : 920-6.
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9) 堀正二, 監修. 坂田泰史, 編集. 図解循環器用語ハンドブック. https://med.toaeiyo.co.jp/contents/cardioterms/pathophysiology/2-27.html (2023年6月閲覧)
 
P.23 掲載の参考文献
1) Zinman B, et al. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med. 2015 ; 373 : 2117-28.
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2) Neal B, et al. Canagliflozin and cardiovascular and renal events in type 2 diabetes. N Engl J Med. 2017 ; 377 : 644-57.
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3) Wiviott SD, et al. Dapagliflozin and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2019 ; 380 : 347-57.
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4) Packer M, et al. Cardiovascular and renal outcomes with empagliflozin in heart failure. N Engl J Med. 2020 ; 383 : 1413-24.
PubMed
5) McMurray JJV, et al. Dapagliflozin in patients with heart failure and reduced ejection fraction. N Engl J Med. 2019 ; 381 : 1995-2008.
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6) Tsutsui H, et al. JCS/JHFS 2021 guideline focused update on diagnosis and treatment of acute and chronic heart failure. Circ J. 2021 ; 85 : 2252-91.
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7) Heidenreich PA, et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure : a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022 : 145 : e895-e1032.
 
8) McDonagh TA, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021 ; 42 : 3599-726.
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9) Anker SD, et al. Empagliflozin in heart failure with a preserved ejection fraction. N Engl J Med. 2021 ; 385 : 1451-61.
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10) Solomon SD, et al. Dapagliflozin in heart failure with mildly reduced or preserved ejection fraction. N Engl J Med. 2022 ; 387 : 1089-98.
 
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P.27 掲載の参考文献
1) 糖尿病治療におけるSGLT2阻害薬の適正使用に関する Recommendation (2014年6月13日策定, 2022年7月26日最新改訂, 2022年6月閲覧). http://www.jds.or.jp/uploads/files/recommendation/SGLT2.pdf
 
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P.33 掲載の参考文献
1) 日本循環器学会/日本心不全学会合同ガイドライン. 急性・慢性心不全診療ガイドライン (2017年改訂版). https://www.j-circ.or.jp/cms/wp-content/uploads/2017/06/JCS2017_tsutsui_h.pdf 2018年3月発行 (2022年4月更新)
 
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3) Greene SJ, et al. Titration of medical therapy for heart failure with reduced ejection fraction. J Am Coll Cardiol. 2019 ; 73 ; 2365-83.
PubMed
4) Izumi K, et al. Low blood pressure and guideline-directed medical therapy in patients with heart failure with reduced ejection fraction. Int J Cardiol. 2023 ; 370 ; 255-62.
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PubMed
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デバイスのControversy

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カテーテル・外科的治療のControversy

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疾病管理・緩和のControversy

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その他のControversy

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