Noncardiac comorbidities in heart failure with reduced versus preserved ejection fraction.
Noncardiac comorbidities in heart failure with reduced versus preserved ejection fraction.
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DOI：
10.1016/j.jacc.2014.08.036
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发表时间：
2014-12-02
影响因子：
24
通讯作者：
O'Connor, Christopher M.
中科院分区：
文献类型：
--
作者：
Mentz, Robert J.;Kelly, Jacob P.;von Lueder, Thomas G.;Voors, Adriaan A.;Lam, Carolyn S. P.;Cowie, Martin R.;Kjeldsen, Keld;Jankowska, Ewa A.;Atar, Dan;Butler, Javed;Fiuzat, Mona;Zannad, Faiez;Pitt, Bertram;O'Connor, Christopher M.
心力衰竭患者根据射血分数（EF）分为不同的组：保留EF的心力衰竭（HFpEF）或EF降低的心力衰竭（HFrEF）。虽然心力衰竭患者通常有多种合并症，使治疗复杂化，并可能对结果产生不利影响，但它们在HFpEF和HFrEF组中的作用尚未得到很好的表征。这篇综述总结了非心脏合并症在HFpEF和HFrEF患者中的作用，强调了患病率、潜在的病理生理机制和结果。肺部疾病、糖尿病、贫血和肥胖在HFpEF患者中更为普遍，但肾脏疾病和睡眠呼吸障碍负担相似。这些合并症同样增加了HFpEF和HFrEF患者的发病率和死亡率风险。常见的病理生理机制包括全身和心内膜炎症伴纤维化。我们还讨论了对临床护理和未来心衰临床试验设计的影响。本综述的基础是第十届全球心血管临床试验者论坛上科学家、临床试验者和监管代表之间的讨论。
Heart failure patients are classified by ejection fraction (EF) into distinct groups: heart failure with preserved EF (HFpEF) or heart failure with reduced EF (HFrEF). Although patients with heart failure commonly have multiple comorbidities that complicate management and may adversely affect outcomes, their role in the HFpEF and HFrEF groups is not well-characterized. This review summarizes the role of noncardiac comorbidities in patients with HFpEF versus HFrEF, emphasizing prevalence, underlying pathophysiologic mechanisms, and outcomes. Pulmonary disease, diabetes mellitus, anemia, and obesity tend to be more prevalent in HFpEF patients, but renal disease and sleep-disordered breathing burdens are similar. These comorbidities similarly increase morbidity and mortality risk in HFpEF and HFrEF patients. Common pathophysiologic mechanisms include systemic and endomyocardial inflammation with fibrosis. We also discuss implications for clinical care and future HF clinical trial design. The basis for this review was discussions between scientists, clinical trialists, and regulatory representatives at the 10th Global CardioVascular Clinical Trialists Forum.
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DOI：
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发表时间：
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影响因子：
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作者：
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影响因子：
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