Yıl: 2017 Cilt: 45 Sayı: Suppl. 5 Sayfa Aralığı: 42 - 46 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Yaşlılarda kalp yetersizliğine yaklaşım

Öz:
Kalp yetersizliği prevalansı yaşla birlikte artmaktadır. Yaşlanma ile birlikte kardiyovasküler sistemin yapı ve fonksiyonlarında birtakım değişiklikler meydana gelmektedir. Diyastolik disfonksiyona neden olan yaşa bağlı bu değişikler nedeniyle yaşlılarda korunmuş ejeksiyon fraksiyonlu kalp yetersizliği daha sıktır. Yaşlılarda kalp yetersizliği tanısı tipik semptom ve bulguların olmamasından dolayı zor olabilir. Yaşlı hastalar kalp yetersizliği tedavisine farklı cevap verebilir. Yaş- lılarda kalp yetersizliği tedavisi için ilaç seçiminde eşlik eden yaşa bağlı fizyolojik değişiklikler, komorbiditeler, ilaç etkileşimleri, ilaç yan etkileri ve hasta uyumu göz önünde bulundurulmalıdır.
Anahtar Kelime:

Konular: Geriatri ve Gerontoloji Kalp ve Kalp Damar Sistemi

Approach to heart failure in the elderly

Öz:
The prevalence of heart failure increases with age. Several specific changes in cardiac structure and function are associated with cardiac ageing. Because of age-associated changes leading to diastolic dysfunction, heart failure with preserved ejection fraction is the most common form of heart failure in the elderly. The diagnosis of heart failure may be difficult to diagnose in elderly patients because of a lack of typical symptoms and physical findings. The elderly patients may respond differently to heart failure medications. Age-associated changes in physiology, comorbidities, drug interaction, medication side-effects, and compliance should be considered when choosing a drug to manage heart failure in the elderly.
Anahtar Kelime:

Konular: Geriatri ve Gerontoloji Kalp ve Kalp Damar Sistemi
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Mosterd A, Hoes AW. Clinical epidemiology of heart failure. Heart 2007;93:1137–46.
  • 2. Lazzarini V, Mentz RJ, Fiuzat M, Metra M, O’Connor CM. Heart failure in elderly patients: distinctive features and unresolved issues. Eur J Heart Fail 2013;15:717–23.
  • 3. Bhatia RS, Tu JV, Lee DS, Austin PC, Fang J, Haouzi A, et al. Outcome of heart failure with preserved ejection fraction in a population-based study. N Engl J Med 2006;355:260–9.
  • 4. Monahan KD. Effect of aging on baroreflex function in humans. Am J Physiol Regul Integr Comp Physiol 2007;293:R3–R12.
  • 5. Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JG, Coats AJ, et al; 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J2016;37:2129–200.
  • 6. Blondé-Cynober F, Morineau G, Estrugo B, Fillie E, Aussel C, Vincent JP. Diagnostic and prognostic value of brain natriuretic peptide (BNP) concentrations in very elderly heart disease patients: specific geriatric cut-off and impacts of age, gender, renal dysfunction, and nutritional status. Arch Gerontol Geriatr 2011;52:106–10.
  • 7. Komajda M, Hanon O, Hochadel M, Lopez-Sendon JL, Follath F, Ponikowski P, et al. Contemporary management of octogenarians hospitalized for heart failure in Europe: Euro Heart Failure Survey II. Eur Heart J 2009;30:478–86.
  • 8. Antonelli Incalzi R, Pedone C, Pahor M, Onder G, Carbonin PU; Gruppo Italiano di Farmacovigilanza nell’Anziano. Trends in prescribing ACE-inhibitors for congestive heart failure in elderly people. Aging Clin Exp Res 2002;14:516–21.
  • 9. Bavishi C, Ahmed M, Trivedi V, Khan AR, Gongora C, Bangalore S, et al. Meta-Analysis of Randomized Trials on the Efficacy and Safety of Angiotensin-Converting Enzyme Inhibitors in Patients ≥65 Years of Age. Am J Cardiol 2016;118:1427–36.
  • 10. Dulin BR, Haas SJ, Abraham WT, Krum H. Do elderly systolic heart failure patients benefit from beta blockers to the same extent as the non-elderly? Meta-analysis of >12,000 patients in large-scale clinical trials. Am J Cardiol 2005;95:896–8.
  • 11. Ghio S, Magrini G, Serio A, Klersy C, Fucili A, Ronaszèki A, et al; SENIORS investigators. Effects of nebivolol in elderly heart failure patients with or without systolic left ventricular dysfunction: results of the SENIORS echocardiographic substudy. Eur Heart J 2006;27:562–8.
  • 12. Digitalis Investigation Group. The effect of digoxin on mortality and morbidity in patients with heart failure. N Engl J Med 1997;336:525–33.
  • 13. Rich MW, McSherry F, Williford WO, Yusuf S; Digitalis Investigation Group. Effect of age on mortality, hospitalizations and response to digoxin in patients with heart failure: the DIG study. J Am Coll Cardiol 2001;38:806–13.
  • 14. Swedberg K, Komajda M, Böhm M, Borer JS, Ford I, Dubost-Brama A, et al; SHIFT Investigators. Ivabradine and outcomes in chronic heart failure (SHIFT): a randomised placebo-controlled study. Lancet 2010;376:875–85.
  • 15. Tavazzi L, Swedberg K, Komajda M, Böhm M, Borer JS, Lainscak M, et al; SHIFT Investigators. Efficacy and safety of ivabradine in chronic heart failure across the age spectrum: insights from the SHIFT study. Eur J Heart Fail 2013;15:1296–303.
  • 16. McMurray JJ, Packer M, Desai AS, Gong J, Lefkowitz MP, Rizkala AR, et al; PARADIGM-HF Investigators and Committees. Angiotensin-neprilysin inhibition versus enalapril in heart failure. N Engl J Med 2014;371:993–1004.
  • 17. Jhund PS, Fu M, Bayram E, Chen CH, Negrusz-Kawecka M, Rosenthal A, et al. Efficacy and safety of LCZ696 (sacubitril-valsartan) according to age: insights from PARADIGM-HF. Eur Heart J 2015;36:2576–84.
  • 18. Epstein AE, Kay GN, Plumb VJ, McElderry HT, Doppalapudi H, Yamada T, et al; ACT Investigators. Implantable cardioverter-defibrillator prescription in the elderly. Heart Rhythm 2009;6:1136–43.
  • 19. Rich MW. Device therapy in the elderly heart failure patient: what is the evidence? Expert Rev Cardiovasc Ther 2010;8:1203–5.
  • 20. Barra S, Providência R, Paiva L, Heck P, Agarwal S. Implantable cardioverterdefibrillators in the elderly: rationale and specific age-related considerations. Europace 2015;17:174–86.
  • 21. Foley PW, Chalil S, Khadjooi K, Smith RE, Frenneaux MP, Leyva F. Long-term effects of cardiac resynchronization therapy in octogenarians: a comparative study with a younger population. Europace 2008;10:1302–7.
  • 22. Cleland JG, Tendera M, Adamus J, Freemantle N, Polonski L, Taylor J; PEPCHF Investigators. The perindopril in elderly people with chronic heart failure (PEP-CHF) study. Eur Heart J 2006;27:2338–45.
  • 23. de Boer RA, Doehner W, van der Horst IC, Anker SD, Babalis D, Roughton M, et al; SENIORS Investigators. Influence of diabetes mellitus and hyperglycemia on prognosis in patients > or =70 years old with heart failure and effects of nebivolol (data from the Study of Effects of Nebivolol Intervention on Outcomes and Rehospitalization in Seniors with heart failure [SENIORS]). Am J Cardiol 2010;106:78–86.e1.
  • 24. Pitt B, Pfeffer MA, Assmann SF, Boineau R, Anand IS, Claggett B, et al; TOPCAT Investigators. Spironolactone for heart failure with preserved ejection fraction. N Engl J Med 2014;370:1383–92.
  • 25. Pfeffer MA, Claggett B, Assmann SF, Boineau R, Anand IS, Clausell N, et al. Regional variation in patients and outcomes in the Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist (TOPCAT) trial. Circulation 2015;131:34–42.
  • 26. Screever EM, Meijers WC, van Veldhuisen DJ, de Boer RA. New developments in the pharmacotherapeutic management of heart failure in elderly patients: concerns and considerations. Expert Opin Pharmacother 2017;18:645–55.
APA Yeşilbursa D (2017). Yaşlılarda kalp yetersizliğine yaklaşım. , 42 - 46.
Chicago Yeşilbursa Dilek Yaşlılarda kalp yetersizliğine yaklaşım. (2017): 42 - 46.
MLA Yeşilbursa Dilek Yaşlılarda kalp yetersizliğine yaklaşım. , 2017, ss.42 - 46.
AMA Yeşilbursa D Yaşlılarda kalp yetersizliğine yaklaşım. . 2017; 42 - 46.
Vancouver Yeşilbursa D Yaşlılarda kalp yetersizliğine yaklaşım. . 2017; 42 - 46.
IEEE Yeşilbursa D "Yaşlılarda kalp yetersizliğine yaklaşım." , ss.42 - 46, 2017.
ISNAD Yeşilbursa, Dilek. "Yaşlılarda kalp yetersizliğine yaklaşım". (2017), 42-46.
APA Yeşilbursa D (2017). Yaşlılarda kalp yetersizliğine yaklaşım. Türk Kardiyoloji Derneği Arşivi, 45(Suppl. 5), 42 - 46.
Chicago Yeşilbursa Dilek Yaşlılarda kalp yetersizliğine yaklaşım. Türk Kardiyoloji Derneği Arşivi 45, no.Suppl. 5 (2017): 42 - 46.
MLA Yeşilbursa Dilek Yaşlılarda kalp yetersizliğine yaklaşım. Türk Kardiyoloji Derneği Arşivi, vol.45, no.Suppl. 5, 2017, ss.42 - 46.
AMA Yeşilbursa D Yaşlılarda kalp yetersizliğine yaklaşım. Türk Kardiyoloji Derneği Arşivi. 2017; 45(Suppl. 5): 42 - 46.
Vancouver Yeşilbursa D Yaşlılarda kalp yetersizliğine yaklaşım. Türk Kardiyoloji Derneği Arşivi. 2017; 45(Suppl. 5): 42 - 46.
IEEE Yeşilbursa D "Yaşlılarda kalp yetersizliğine yaklaşım." Türk Kardiyoloji Derneği Arşivi, 45, ss.42 - 46, 2017.
ISNAD Yeşilbursa, Dilek. "Yaşlılarda kalp yetersizliğine yaklaşım". Türk Kardiyoloji Derneği Arşivi 45/Suppl. 5 (2017), 42-46.