Deep Phenotyping of Systemic Arterial Hemodynamics in HFpEF (Part 2): Clinical and Therapeutic Considerations.
Deep Phenotyping of Systemic Arterial Hemodynamics in HFpEF (Part 2): Clinical and Therapeutic Considerations.
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DOI：
10.1007/s12265-017-9736-2
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发表时间：
2017-06
影响因子：
3.4
通讯作者：
Chirinos JA
中科院分区：
文献类型：
--
作者：
Chirinos JA
过去几十年的多项 III 期试验未能证明各种药物干预对左心室 (LV) 射血分数 (HFpEF) 保留的心力衰竭有明显的益处。因此，更好地了解其病理生理学非常重要。随附的综述描述了有关 HFpEF 动脉血流动力学深层表型的关键技术和生理学方面。这篇综述探讨了这种方法在增强 HFpEF 临床、转化和治疗方法方面的潜力。具体而言，讨论了动脉血流动力学的作用，涉及以下方面：(1) 左心室舒张功能障碍、重构和纤维化的病理生理学；(2) 外周骨骼肌的氧输送受损，从而影响外周氧提取；(3) 该人群中频繁出现的合并症，如肾功能衰竭和痴呆；(4) 增强精准医疗方法的潜力。还讨论了针对该人群中普遍存在的动脉血流动力学异常的治疗方法（特别是无机硝酸盐/亚硝酸盐）。
Multiple phase III trials over the last few decades have failed to demonstrate a clear benefit of various pharmacologic interventions in heart failure with a preserved left ventricular (LV) ejection fraction (HFpEF). Therefore, a better understanding of its pathophysiology is important. An accompanying review describes key technical and physiologic aspects regarding the deep phenotyping of arterial hemodynamics in HFpEF. This review deals with the potential of this approach to enhance our clinical, translational, and therapeutic approach to HFpEF. Specifically, the role of arterial hemodynamics is discussed in relation to (1) the pathophysiology of left ventricular diastolic dysfunction, remodeling, and fibrosis, (2) impaired oxygen delivery to peripheral skeletal muscle, which affects peripheral oxygen extraction, (3) the frequent presence of comorbidities, such as renal failure and dementia in this population, and (4) the potential to enhance precision medicine approaches. A therapeutic approach to target arterial hemodynamic abnormalities that are prevalent in this population (particularly, with inorganic nitrate/nitrite) is also discussed.
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影响因子：
0.6
作者：
Chirinos, Julio A
通讯作者：
Chirinos, Julio A
影响因子：
24
作者：
Chirinos, Julio A.;Kips, Jan G.;Jacobs, David R., Jr.;Brumback, Lyndia;Duprez, Daniel A.;Kronmal, Richard;Bluemke, David A.;Townsend, Raymond R.;Vermeersch, Sebastian;Segers, Patrick
通讯作者：
Segers, Patrick
DOI：
10.1016/j.jchf.2015.12.013
发表时间：
2016-06
期刊：
JACC. Heart failure
影响因子：
--
作者：
Eggebeen J;Kim-Shapiro DB;Haykowsky M;Morgan TM;Basu S;Brubaker P;Rejeski J;Kitzman DW
通讯作者：
Kitzman DW
影响因子：
8.3
作者：
Booysen, Hendrik L.;Woodiwiss, Angela J.;Norton, Gavin R.
通讯作者：
Norton, Gavin R.
影响因子：
--
作者：
Chirinos, Julio A;Zamani, Payman
通讯作者：
Zamani, Payman