尽管有许多可用的方法来预测心力衰竭患者的预后,但预后仍然很差,这可能是因为患者存在明显的异质性和心力衰竭病因。因此,确定新的预后指标以对心力衰竭患者的风险进行分层至关重要。脾脏正在成为心力衰竭潜在的新型预后指标。在本文中,我们概述了当前用于心力衰竭的预后工具。然后我们介绍脾脏作为潜在的新型预后指标,然后概述脾脏的结构和功能并介绍心脾轴的概念。随后重点讨论了脾脏在免疫反应和血液动力学中的功能,以及对已知脾脏作为心力衰竭指标的有用性的回顾。提供了对预测心力衰竭患者最有效的脾脏相关测量指标的专家见解,并考虑了如何在临床实践中测量这些指标的建议。未来,将需要对人体进行研究,以确定特定脾脏测量值与不同心力衰竭表现之间的明确联系,以及确定脾脏预后测量值是否因心力衰竭类别和病因而异。这些贡献将使我们对脾脏作为心力衰竭预后预测因子的有用性的理解向前迈进了一步。提供了对预测心力衰竭患者最有效的脾脏相关测量指标的专家见解,并考虑了如何在临床实践中测量这些指标的建议。未来,将需要对人体进行研究,以确定特定脾脏测量值与不同心力衰竭表现之间的明确联系,以及确定脾脏预后测量值是否因心力衰竭类别和病因而异。这些贡献将使我们对脾脏作为心力衰竭预后预测因子的有用性的理解向前迈进了一步。提供了对预测心力衰竭患者最有效的脾脏相关测量指标的专家见解,并考虑了如何在临床实践中测量这些指标的建议。未来,将需要对人体进行研究,以确定特定脾脏测量值与不同心力衰竭表现之间的明确联系,以及确定脾脏预后测量值是否因心力衰竭类别和病因而异。这些贡献将使我们对脾脏作为心力衰竭预后预测因子的有用性的理解向前迈进了一步。需要对人体进行研究,以确定特定脾脏测量值与不同心力衰竭表现之间的明确联系,以及确定脾脏预后测量值是否因心力衰竭类别和病因而异。这些贡献将使我们对脾脏作为心力衰竭预后预测因子的有用性的理解向前迈进了一步。需要对人体进行研究,以确定特定脾脏测量值与不同心力衰竭表现之间的明确联系,以及确定脾脏预后测量值是否因心力衰竭类别和病因而异。这些贡献将使我们对脾脏作为心力衰竭预后预测因子的有用性的理解向前迈进了一步。
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The cardiosplenic axis: the prognostic role of the spleen in heart failure
Despite the number of available methods to predict prognosis in patients with heart failure, prognosis remains poor, likely because of marked patient heterogeneity and varied heart failure etiologies. Thus, identification of novel prognostic indicators to stratify risk in patients with heart failure is of paramount importance. The spleen is emerging as a potential novel prognostic indicator for heart failure. In this article, we provide an overview of the current prognostic tools used for heart failure. We then introduce the spleen as a potential novel prognostic indicator, before outlining the structure and function of the spleen and introducing the concept of the cardiosplenic axis. This is followed by a focused discussion on the function of the spleen in the immune response and in hemodynamics, as well as a review of what is known about the usefulness of the spleen as an indicator of heart failure. Expert insight into the most effective spleen-related measurement indices for the prognostication of patients with heart failure is provided, and suggestions on how these could be measured in clinical practice are considered. In future, studies in humans will be required to draw definitive links between specific splenic measurements and different heart failure manifestations, as well as to determine whether splenic prognostic measurements differ between heart failure classes and etiologies. These contributions will provide a step forward in our understanding of the usefulness of the spleen as a prognostic predictor in heart failure.