medicina57巻10号

2020年09月発行

特集 循環器診療2020—どこまで攻めて，どこから引くか？ 心不全

心不全慢性期の至適薬物治療を適切に導入するために

著者： 河野隆志¹

所属機関： ¹杏林大学医学部循環器内科学

ページ範囲：P.1674 - P.1677

Point
◎左室駆出率の低下した心不全（HFrEF）患者では，ACE阻害薬（またはARB）とβ遮断薬を導入する．
◎ACE阻害薬とβ遮断薬導入後で，症候性かつ左室駆出率が35％未満の場合は，ミネラルコルチコイド受容体拮抗薬を追加する．
◎ランダム化比較試験に反映されにくい集団（高齢者など）における真の至適薬物治療の検証が待たれる．

参考文献

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2）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_オリジナル版_190830.pdf（2020年7月閲覧）

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