{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T02:26:49Z","timestamp":1783045609507,"version":"3.54.6"},"reference-count":35,"publisher":"Akademiai Kiado Zrt.","issue":"31","content-domain":{"domain":["www.akjournals.com"],"crossmark-restriction":true},"short-container-title":["OH"],"published-print":{"date-parts":[[2024,8,4]]},"abstract":"<jats:p>\n                    <jats:italic>Bevezet\u00e9s:<\/jats:italic>\n                    Az Eur\u00f3pai Kardiol\u00f3gus T\u00e1rsas\u00e1g 2023-ban meg\u00faj\u00edtott\n                    Sz\u00edvel\u00e9gtelens\u00e9g Ir\u00e1nyelve gyors\u00edtott ter\u00e1piaoptimaliz\u00e1ci\u00f3t javasol minden,\n                    sz\u00edvel\u00e9gtelens\u00e9gben szenved\u0151 beteg sz\u00e1m\u00e1ra hospitaliz\u00e1ci\u00f3t k\u00f6vet\u0151en a progn\u00f3zis\n                    jav\u00edt\u00e1sa \u00e9rdek\u00e9ben a STRONG-HF vizsg\u00e1lat alapj\u00e1n. Ugyanakkor a STRONG-HF\n                    vizsg\u00e1lat szigor\u00fa randomiz\u00e1ci\u00f3s krit\u00e9riumokkal rendelkezett, \u00edgy a napi\n                    gyakorlatban sz\u00e9les k\u00f6r\u0171 megval\u00f3s\u00edthat\u00f3s\u00e1g\u00e1r\u00f3l nem \u00e1llnak rendelkez\u00e9sre adatok.\n                    <jats:italic>C\u00e9lkit\u0171z\u00e9s \u00e9s m\u00f3dszer:<\/jats:italic>\n                    C\u00e9lkit\u0171z\u00e9s\u00fcnk int\u00e9zet\u00fcnk\n                    Sz\u00edvel\u00e9gtelens\u00e9g R\u00e9szleg\u00e9n hospitaliz\u00e1lt, majd Sz\u00edvel\u00e9gtelens\u00e9g Ambulanci\u00e1nkon\n                    k\u00f6vetett, kilenc, egym\u00e1st k\u00f6vet\u0151 gyors\u00edtott ter\u00e1piaoptimaliz\u00e1ci\u00f3n \u00e1tesett,\n                    cs\u00f6kkent ejekci\u00f3s frakci\u00f3j\u00fa sz\u00edvel\u00e9gtelens\u00e9gben szenved\u0151 beteg retrospekt\u00edv\n                    pilotvizsg\u00e1lat\u00e1nak bemutat\u00e1sa. A gyors\u00edtott ter\u00e1piaoptimaliz\u00e1ci\u00f3ra val\u00f3\n                    alkalmass\u00e1guk meghat\u00e1roz\u00e1sa a STRONG-HF vizsg\u00e1lat alapj\u00e1n fel\u00e1ll\u00edtott\n                    krit\u00e9riumok szerint t\u00f6rt\u00e9nt (systol\u00e9s v\u00e9rnyom\u00e1s \u2265100 Hgmm, sz\u00edvfrekvencia \u226560\n                        min\n                    <jats:sup>\u20131<\/jats:sup>\n                    , sz\u00e9rumk\u00e1liumszint \u22645 mmol\/l, becs\u00fclt glomerularis\n                    filtr\u00e1ci\u00f3 \u226530 ml\/min\/1,73 m\n                    <jats:sup>2<\/jats:sup>\n                    ).\n                    <jats:italic>Eredm\u00e9nyek:<\/jats:italic>\n                    Vizsg\u00e1lt\n                    betegeink \u00e9letkora 33 \u00e9s 74 \u00e9v k\u00f6z\u00f6tti, a felv\u00e9teli NT-proBNP medi\u00e1n\u00e9rt\u00e9ke 4786\n                    (1670\u201313283) pg\/ml, a becs\u00fclt glomerularis filtr\u00e1ci\u00f3s r\u00e1ta 92 (58\u2013101)\n                    ml\/min\/1,73 m\n                    <jats:sup>2<\/jats:sup>\n                    , a sz\u00e9rumk\u00e1liumszint 3,9 (3,6\u20134,3) mmol\/l, a systol\u00e9s\n                    v\u00e9rnyom\u00e1s 134 (115\u2013136) Hgmm, a sz\u00edvfrekvencia 113 (96\u2013134) min\n                    <jats:sup>\u20131<\/jats:sup>\n                    , a\n                    bal kamrai ejekci\u00f3s frakci\u00f3 23 (20\u201334)% volt. A k\u00f3rh\u00e1zi felv\u00e9telkor egy-egy\n                    betegn\u00e9l c\u00e9ld\u00f3zis alatti n\u00e9gyes \u00e9s h\u00e1rmas ter\u00e1pia ker\u00fclt alkalmaz\u00e1sra, m\u00edg a\n                    t\u00f6bbi esetben a strat\u00e9giai gy\u00f3gyszerek k\u00f6z\u00fcl kett\u0151 vagy kevesebb\n                    gy\u00f3gyszercsoportot alkalmaztunk. Elbocs\u00e1t\u00e1skor egy beteg kiv\u00e9tel\u00e9vel bevezet\u00e9sre\n                    ker\u00fclt a n\u00e9gyes ter\u00e1pia: RASi (renin-angiotenzin-rendszer-g\u00e1tl\u00f3) eset\u00e9n az el\u00e9rt\n                    d\u00f3zis \u00e1tlagosan a c\u00e9ld\u00f3zis 61%-a, \u03b2B (b\u00e9ta-blokkol\u00f3) eset\u00e9n a 26%-a, MRA\n                    (mineralokortikoidreceptor-antagonista) eset\u00e9n a 97%-a volt, SGLT2i-\n                    (n\u00e1trium-gl\u00fck\u00f3z-kotranszporter-2-g\u00e1tl\u00f3) kezel\u00e9sben nyolc beteg r\u00e9szes\u00fclt. A\n                    hathetes ut\u00e1nk\u00f6vet\u00e9s sor\u00e1n jelent\u0151s sz\u00f6v\u0151dm\u00e9ny nem jelentkezett. A gyors\u00edtott\n                    ter\u00e1piaoptimaliz\u00e1ci\u00f3t k\u00f6vet\u0151en RASi eset\u00e9n \u00e1tlagosan a c\u00e9ld\u00f3zis 94%-\u00e1t, \u03b2B\n                    eset\u00e9n a 93%-\u00e1t, MRA \u00e9s SGLT2i eset\u00e9n a 100%-\u00e1t \u00e9rt\u00fck el. Hat beteg eset\u00e9n\n                    c\u00e9ld\u00f3zis\u00fa n\u00e9gyes ter\u00e1pia ker\u00fclt feltitr\u00e1l\u00e1sra, m\u00edg h\u00e1rom esetben a t\u00fcnetes\n                    hypotonia \u00e9s\/vagy bradycardia g\u00e1tolta a RASi \u00e9s \u03b2B d\u00f3zisemel\u00e9s\u00e9t. A betegek\n                    visszajelz\u00e9sei alapj\u00e1n a gyors\u00edtott ter\u00e1piaoptimaliz\u00e1ci\u00f3 nem jelentett jelent\u0151s\n                    megterhel\u00e9st, a szoros kontroll azonban n\u00f6velte a biztons\u00e1g\u00e9rzet\u00fcket.\n                    <jats:italic>K\u00f6vetkeztet\u00e9s:<\/jats:italic>\n                    Eseteink alapj\u00e1n a sz\u00edvel\u00e9gtelens\u00e9g els\u0151\n                    vonalbeli gy\u00f3gyszeres kezel\u00e9s\u00e9nek a nemzetk\u00f6zi ir\u00e1nyelv szerinti gyors\u00edtott\n                    ter\u00e1piaoptimaliz\u00e1ci\u00f3ja kivitelezhet\u0151 \u00e9s biztons\u00e1gos volt a sz\u00edvel\u00e9gtelens\u00e9g\n                    miatti hospitaliz\u00e1ci\u00f3t k\u00f6vet\u0151en. A betegeken nagy d\u00f3zis\u00fa n\u00e9gyes ter\u00e1pia volt\n                    el\u00e9rhet\u0151. A gyors\u00edtott ter\u00e1piaoptimaliz\u00e1ci\u00f3 mind a klinikust\u00f3l, mind a betegt\u0151l\n                    kell\u0151 odafigyel\u00e9st ig\u00e9nyelt. Orv Hetil. 2024; 165(31): 1197\u20131205.\n                  <\/jats:p>","DOI":"10.1556\/650.2024.33081","type":"journal-article","created":{"date-parts":[[2024,8,15]],"date-time":"2024-08-15T01:24:24Z","timestamp":1723685064000},"page":"1197-1205","update-policy":"https:\/\/doi.org\/10.1556\/policypage.crossmark.crossref.2","source":"Crossref","is-referenced-by-count":5,"title":["Gyors\u00edtott ter\u00e1piaoptimaliz\u00e1ci\u00f3 sz\u00edvel\u00e9gtelens\u00e9gben hospitaliz\u00e1ci\u00f3n \u00e1tesett betegeken"],"prefix":"10.1556","volume":"165","author":[{"given":"G. Tam\u00e1s","family":"Gergely","sequence":"first","affiliation":[{"name":"Gottsegen Gy\u00f6rgy Orsz\u00e1gos Kardiovaszkul\u00e1ris Int\u00e9zet, Feln\u0151tt Kardiol\u00f3giai Oszt\u00e1ly Budapest, Haller u. 29., 1096 Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fanni","family":"B\u00e1nfi-Bacs\u00e1rdi","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"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Kom\u00e1romi","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"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"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":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabet Mirjam","family":"Boldizs\u00e1r","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"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorottya","family":"Flegler","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":"\u00c9szak-pesti Centrumk\u00f3rh\u00e1z \u2013 Honv\u00e9dk\u00f3rh\u00e1z, Kardiol\u00f3giai Oszt\u00e1ly Budapest Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1d\u00e1m","family":"Kazay","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"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tam\u00e1s","family":"F\u00fczesi","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"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zsolt","family":"Forrai","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"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivien","family":"V\u00e9rtes","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"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V. Nabil","family":"Sayour","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"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P\u00e9ter","family":"Andr\u00e9ka","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"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zsolt","family":"Pir\u00f3th","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"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"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"},{"name":"\u00c9szak-pesti Centrumk\u00f3rh\u00e1z \u2013 Honv\u00e9dk\u00f3rh\u00e1z, Kardiol\u00f3giai Oszt\u00e1ly Budapest Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"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":[{"vocabulary":"crossref","role":"author"}]}],"member":"425","reference":[{"key":"R1","doi-asserted-by":"crossref","unstructured":"Savarese G, Becher PM, Lund LH, et al. Global burden of heart\n                    failure: a comprehensive and updated review of epidemiology. Cardiovasc Res.\n                    2023; 118: 3272\u20133287.","DOI":"10.1093\/cvr\/cvac013"},{"key":"R2","doi-asserted-by":"crossref","unstructured":"Muk B, Pilecky D, B\u00e1nfi-Bacs\u00e1rdi F, et al. The changes in the\n                    pharmacotherapy of heart failure with reduced ejection fraction and its effect\n                    on prognosis: experience in Hungarian clinical practice. [A cs\u00f6kkent ejekci\u00f3s\n                    frakci\u00f3j\u00fa sz\u00edvel\u00e9gtelens\u00e9g gy\u00f3gyszeres kezel\u00e9s\u00e9nek v\u00e1ltoz\u00e1sa \u00e9s a progn\u00f3zisra\n                    gyakorolt hat\u00e1sa a hazai gyakorlatban.] Orv Hetil. 2024; 165: 698\u2013710.\n                    [Hungarian]","DOI":"10.1556\/650.2024.33045"},{"key":"R3","doi-asserted-by":"crossref","unstructured":"McDonagh TA, Metra M, Adamo M, et al. 2021 ESC guidelines for the\n                    diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021;\n                    42: 3599\u20133726. 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Erratum: Eur Heart J. 2024; 45:\n                    53.","DOI":"10.1093\/eurheartj\/ehad613"},{"key":"R6","doi-asserted-by":"crossref","unstructured":"Mebazaa A, Davison B, Chioncel O, et al. Safety, tolerability and\n                    efficacy of up-titration of guideline-directed medical therapies for acute heart\n                    failure (STRONG-HF): a multinational, open-label, randomised, trial. Lancet\n                    2022; 400: 1938\u20131952.","DOI":"10.1016\/S0140-6736(22)02076-1"},{"key":"R7","doi-asserted-by":"crossref","unstructured":"Williams B, Mancia G, Spiering W, et al. 2018 ESC\/ESH guidelines for\n                    the management of arterial hypertension. Eur Heart J. 2018; 39:\n                    3021\u20133104.","DOI":"10.1093\/eurheartj\/ehy439"},{"key":"R8","doi-asserted-by":"crossref","unstructured":"Tomasoni D, Davison B, Adamo M, et al. Safety indicators in patients\n                    receiving high-intensity care after hospital admission for acute heart failure.\n                    The STRONG-HF trial. J Card Fail. 2024; 30: 525\u2013537.","DOI":"10.1016\/j.cardfail.2023.09.002"},{"key":"R9","doi-asserted-by":"crossref","unstructured":"Vaduganathan M, Claggett BL, Jhund PS, et al. Estimating lifetime\n                    benefits of comprehensive disease-modifying pharmacological therapies in\n                    patients with heart failure with reduced ejection fraction: a comparative\n                    analysis of three randomised controlled trials. Lancet 2020; 396:\n                    121\u2013128.","DOI":"10.1016\/S0140-6736(20)30748-0"},{"key":"R10","doi-asserted-by":"crossref","unstructured":"Greene SJ, Butler J, Albert NM, et al. Medical therapy for heart\n                    failure with reduced ejection fraction. The CHAMP-HF registry. 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Rapid evidence-based sequencing of\n                    foundational drugs for heart failure and a reduced ejection fraction. Eur J\n                    Heart Fail. 2021; 23: 882\u2013894.","DOI":"10.1002\/ejhf.2149"},{"key":"R14","doi-asserted-by":"crossref","unstructured":"Greene SJ, Butler J, Fonarow GC. Simultaneous or rapid sequence\n                    initiation of quadruple medical therapy for heart failure-optimizing therapy\n                    with the need for speed. JAMA Cardiol. 2021; 6: 743\u2013744.","DOI":"10.1001\/jamacardio.2021.0496"},{"key":"R15","doi-asserted-by":"crossref","unstructured":"Shen L, Jhund PS, Docherty KF, et al. Accelerated and personalized\n                    therapy for heart failure with reduced ejection fraction. Eur Heart J. 2022; 43:\n                    2573\u20132587.","DOI":"10.1093\/eurheartj\/ehac210"},{"key":"R16","doi-asserted-by":"crossref","unstructured":"Rosano GM, Moura B, Metra M, et al. 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