{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T20:12:24Z","timestamp":1774383144378,"version":"3.50.1"},"reference-count":59,"publisher":"Akademiai Kiado Zrt.","issue":"35","license":[{"start":{"date-parts":[[2023,9,3]],"date-time":"2023-09-03T00:00:00Z","timestamp":1693699200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["akjournals.com"],"crossmark-restriction":true},"short-container-title":["OH"],"published-print":{"date-parts":[[2023,9,3]]},"abstract":"<jats:p><jats:italic>Bevezet\u00e9s:<\/jats:italic> Cs\u00f6kkent ejekci\u00f3s frakci\u00f3j\u00fa sz\u00edvel\u00e9gtelens\u00e9gben\n                    (HFrEF) szenved\u0151 betegekben az ir\u00e1nyelvekben javasolt gy\u00f3gyszeres ter\u00e1pia\n                    bevezet\u00e9s\u00e9nek \u00e9s a c\u00e9ld\u00f3zis el\u00e9r\u00e9s\u00e9nek egyik f\u0151 limit\u00e1l\u00f3 t\u00e9nyez\u0151je a\n                    vesefunkci\u00f3-k\u00e1rosod\u00e1s. <jats:italic>C\u00e9lkit\u0171z\u00e9s:<\/jats:italic> Egycentrumos, retrospekt\u00edv\n                    vizsg\u00e1latunk c\u00e9lja a kombin\u00e1lt neurohormon\u00e1lis antagonista h\u00e1rmas ter\u00e1pia (RASi:\n                    ACEI\/ARB\/ARNI + b\u00e9ta-blokkol\u00f3 + MRA) alkalmaz\u00e1si ar\u00e1ny\u00e1nak, valamint a 12\n                    h\u00f3napos \u00f6sszmortalit\u00e1snak az elemz\u00e9se a vesefunkci\u00f3-k\u00e1rosod\u00e1s s\u00falyoss\u00e1g\u00e1nak\n                    f\u00fcggv\u00e9ny\u00e9ben, sz\u00edvel\u00e9gtelens\u00e9g klinikai t\u00fcnetegy\u00fcttese miatt hospitaliz\u00e1lt\n                    HFrEF-betegpopul\u00e1ci\u00f3ban. <jats:italic>M\u00f3dszer:<\/jats:italic> Tercier kardiol\u00f3giai\n                    centrumunk Sz\u00edvel\u00e9gtelens\u00e9g R\u00e9szleg\u00e9n 2019 \u00e9s 2021 k\u00f6z\u00f6tt hospitaliz\u00e1lt,\n                    konszekut\u00edv HFrEF-betegpopul\u00e1ci\u00f3 adatait elemezt\u00fck. A h\u00e1rmas ter\u00e1pia alkalmaz\u00e1si\n                    gyakoris\u00e1g\u00e1t a k\u00f3rh\u00e1zi elbocs\u00e1t\u00e1skor, a felv\u00e9teli becs\u00fclt glomerularis\n                    filtr\u00e1ci\u00f3s r\u00e1ta (eGFR) alapj\u00e1n fel\u00e1ll\u00edtott \u00f6t alcsoportban (eGFR\u226590, eGFR =\n                    60\u201389, eGFR = 45\u201359, eGFR = 30\u201344, eGFR&lt;30 ml\/min\/1,73 m<jats:sup>2<\/jats:sup>)\n                    khi-n\u00e9gyzet-pr\u00f3b\u00e1val, a mortalit\u00e1sbeli k\u00fcl\u00f6nbs\u00e9geket Kaplan\u2013Meier-anal\u00edzissel \u00e9s\n                    log-rank teszttel hasonl\u00edtottuk \u00f6ssze. <jats:italic>Eredm\u00e9nyek:<\/jats:italic>\n                    Vizsg\u00e1latunkban 257 beteg adatait elemezt\u00fck. A felv\u00e9teli medi\u00e1n eGFR 57 (39\u201375)\n                    ml\/min\/1,73 m<jats:sup>2<\/jats:sup> volt, a betegek 54%-a 60 ml\/min\/1,73 m<jats:sup>2<\/jats:sup>\n                    alatti eGFR-rel rendelkezett. A bevont betegek ar\u00e1nya az eGFR\u226590, 60\u201389, 45\u201359,\n                    30\u201344, &lt;30 ml\/min\/1,73 m<jats:sup>2<\/jats:sup> csoportokban 12%, 34%, 18%, 21%, 15%\n                    volt. Regul\u00e1ris dial\u00edzisben 2%-uk r\u00e9szes\u00fclt. B\u00e1r a teljes betegcsoport\n                    kiemelked\u0151en nagy ar\u00e1nyban r\u00e9szes\u00fclt h\u00e1rmas ter\u00e1pi\u00e1ban (77%), az el\u0151rehaladott\n                    vesefunkci\u00f3-k\u00e1rosod\u00e1s a h\u00e1rmas ter\u00e1pia szignifik\u00e1nsan kisebb alkalmaz\u00e1si\n                    ar\u00e1ny\u00e1hoz vezetett (94%, 86%, 91%, 70%, 34%, p&lt;0,0001). Mind a RASi- (100%,\n                    98%, 96%, 89%, 50%, p&lt;0,0001), mind a b\u00e9ta-blokkol\u00f3 (94%, 88%, 96%, 79%, 68%;\n                    p = 0,003), mind az MRA- (97%, 99%, 98%, 94%, 82%; p = 0,001) kezel\u00e9s\n                    alkalmaz\u00e1si ar\u00e1nya k\u00fcl\u00f6nb\u00f6z\u00f6tt az alcsoportokban. A 12 h\u00f3napos \u00f6sszmortalit\u00e1s\n                    23% volt a teljes kohorszban. A hal\u00e1loz\u00e1si r\u00e1ta nagyobbnak bizonyult az\n                    el\u0151rehaladott vesefunkci\u00f3-k\u00e1rosod\u00e1sban szenved\u0151 betegek eset\u00e9n (3%, 15%, 22%,\n                    31%, 46%, p&lt;0,0001). <jats:italic>K\u00f6vetkeztet\u00e9s:<\/jats:italic> Eredm\u00e9nyeink alapj\u00e1n a\n                    teljes betegcsoport kiemelked\u0151en nagy ar\u00e1nyban r\u00e9szes\u00fclt h\u00e1rmas ter\u00e1pi\u00e1ban,\n                    azonban az el\u0151rehaladott vesefunkci\u00f3-k\u00e1rosod\u00e1s a h\u00e1rmas ter\u00e1pia szignifik\u00e1nsan\n                    kisebb alkalmaz\u00e1si ar\u00e1ny\u00e1hoz vezetett, mely kedvez\u0151tlenebb t\u00fal\u00e9l\u00e9ssel p\u00e1rosult.\n                    Eredm\u00e9nyeink felh\u00edvj\u00e1k a figyelmet arra, hogy m\u00e9g el\u0151rehaladott\n                    vesefunkci\u00f3-k\u00e1rosod\u00e1s eset\u00e9n is meg kell k\u00eds\u00e9relni a HFrEF kezel\u00e9s\u00e9ben\n                    strat\u00e9giai fontoss\u00e1g\u00fa k\u00e9sz\u00edtm\u00e9nyek sz\u00e9les k\u00f6r\u0171 alkalmaz\u00e1s\u00e1t. Orv Hetil. 2023;\n                    164(35): 1387\u20131396.<\/jats:p>","DOI":"10.1556\/650.2023.32836","type":"journal-article","created":{"date-parts":[[2023,9,4]],"date-time":"2023-09-04T14:55:31Z","timestamp":1693839331000},"page":"1387-1396","update-policy":"https:\/\/doi.org\/10.1556\/policypage.crossmark.crossref.2","source":"Crossref","is-referenced-by-count":8,"title":["A vesefunkci\u00f3 hat\u00e1sa a gy\u00f3gyszeres ter\u00e1pia optimaliz\u00e1l\u00e1s\u00e1ra \u00e9s a mortalit\u00e1sra cs\u00f6kkent ejekci\u00f3s frakci\u00f3j\u00fa sz\u00edvel\u00e9gtelens\u00e9gben"],"prefix":"10.1556","volume":"164","author":[{"given":"Fanni","family":"B\u00e1nfi-Bacs\u00e1rdi","sequence":"first","affiliation":[{"name":"\u00c9szak-Pesti Centrumk\u00f3rh\u00e1z \u2013 Honv\u00e9dk\u00f3rh\u00e1z, Kardiol\u00f3giai Oszt\u00e1ly Budapest Magyarorsz\u00e1g"},{"name":"Gottsegen Gy\u00f6rgy Orsz\u00e1gos Kardiovaszkul\u00e1ris Int\u00e9zet, Feln\u0151tt Kardiol\u00f3giai Oszt\u00e1ly Budapest, Haller u. 29., 1096 Magyarorsz\u00e1g"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M\u00e1t\u00e9","family":"V\u00e1mos","sequence":"additional","affiliation":[{"name":"Szegedi Tudom\u00e1nyegyetem, Szent-Gy\u00f6rgyi Albert Orvostudom\u00e1nyi Kar, Belgy\u00f3gy\u00e1szati Klinika, Elektrofiziol\u00f3giai R\u00e9szleg Szeged Magyarorsz\u00e1g"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zsuzsanna","family":"Majoros","sequence":"additional","affiliation":[{"name":"\u00c9szak-Pesti Centrumk\u00f3rh\u00e1z \u2013 Honv\u00e9dk\u00f3rh\u00e1z, Kardiol\u00f3giai Oszt\u00e1ly Budapest Magyarorsz\u00e1g"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G\u00e1bor","family":"T\u00f6r\u00f6k","sequence":"additional","affiliation":[{"name":"\u00c9szak-Pesti Centrumk\u00f3rh\u00e1z \u2013 Honv\u00e9dk\u00f3rh\u00e1z, Kardiol\u00f3giai Oszt\u00e1ly Budapest Magyarorsz\u00e1g"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D\u00e1vid","family":"Pilecky","sequence":"additional","affiliation":[{"name":"Gottsegen Gy\u00f6rgy Orsz\u00e1gos Kardiovaszkul\u00e1ris Int\u00e9zet, Feln\u0151tt Kardiol\u00f3giai Oszt\u00e1ly Budapest, Haller u. 29., 1096 Magyarorsz\u00e1g"},{"name":"Szegedi Tudom\u00e1nyegyetem, Szent-Gy\u00f6rgyi Albert Orvostudom\u00e1nyi Kar, Klinikai Orvostudom\u00e1nyi Doktori Iskola Szeged Magyarorsz\u00e1g"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G\u00e1bor Zolt\u00e1n","family":"Duray","sequence":"additional","affiliation":[{"name":"\u00c9szak-Pesti Centrumk\u00f3rh\u00e1z \u2013 Honv\u00e9dk\u00f3rh\u00e1z, Kardiol\u00f3giai Oszt\u00e1ly Budapest Magyarorsz\u00e1g"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R\u00f3bert G\u00e1bor","family":"Kiss","sequence":"additional","affiliation":[{"name":"\u00c9szak-Pesti Centrumk\u00f3rh\u00e1z \u2013 Honv\u00e9dk\u00f3rh\u00e1z, Kardiol\u00f3giai Oszt\u00e1ly Budapest Magyarorsz\u00e1g"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"No\u00e9mi","family":"Nyolczas","sequence":"additional","affiliation":[{"name":"Gottsegen Gy\u00f6rgy Orsz\u00e1gos Kardiovaszkul\u00e1ris Int\u00e9zet, Feln\u0151tt Kardiol\u00f3giai Oszt\u00e1ly Budapest, Haller u. 29., 1096 Magyarorsz\u00e1g"},{"name":"Szegedi Tudom\u00e1nyegyetem, Szent-Gy\u00f6rgyi Albert Orvostudom\u00e1nyi Kar, Klinikai Orvostudom\u00e1nyi Doktori Iskola Szeged Magyarorsz\u00e1g"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bal\u00e1zs","family":"Muk","sequence":"additional","affiliation":[{"name":"Gottsegen Gy\u00f6rgy Orsz\u00e1gos Kardiovaszkul\u00e1ris Int\u00e9zet, Feln\u0151tt Kardiol\u00f3giai Oszt\u00e1ly Budapest, Haller u. 29., 1096 Magyarorsz\u00e1g"},{"name":"Szegedi Tudom\u00e1nyegyetem, Szent-Gy\u00f6rgyi Albert Orvostudom\u00e1nyi Kar, Klinikai Orvostudom\u00e1nyi Doktori Iskola Szeged Magyarorsz\u00e1g"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"425","reference":[{"key":"ref0","doi-asserted-by":"publisher","first-page":"1342","DOI":"10.1002\/ejhf.1858","article-title":"Epidemiology of heart failure","volume":"22","author":"1 Groenewegen","year":"2020","unstructured":"1 Groenewegen A, Rutten FH, Mosterd A, et al. 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