Heart Failure with Preserved Ejection Fraction: Persistent Diagnosis, Therapeutic Enigma.
Heart Failure with Preserved Ejection Fraction: Persistent Diagnosis, Therapeutic Enigma.
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DOI：
10.1007/s12170-011-0184-2
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发表时间：
2011-10
影响因子：
1.9
通讯作者：
Maurer, Mathew S
中科院分区：
文献类型：
--
作者：
Bhuiyan, Taslima;Maurer, Mathew S
随着人口老龄化，射血分数保留的心力衰竭（HFPEF）的患病率不断增加，其发病率和死亡率与射血分数降低的心力衰竭（HFREF）相当。由于存在多种具有混杂症状的合并症，因此诊断可能很困难，尤其是对于老年人。新的诊断工具已经提出了定义和诊断 HFPEF 的指南。最近关注该疾病病理生理学的文献表明，表型的产生涉及多种机制，例如异常松弛和心室-血管耦合、变时性功能不全、容量超负荷以及再分配和/或内皮功能障碍。目前，没有经过临床证明的治疗方法可以降低该人群的发病率和死亡率；然而，可能有一种新的多学科和多阶段治疗策略可以研究来解决这种复杂的疾病，其中结合了药物和非药物治疗。
Heart failure with preserved ejection fraction (HFPEF) is increasing in prevalence with the aging of the population, and morbidity and mortality rates are comparable to that of heart failure with reduced ejection fraction (HFREF). The diagnosis can be difficult to make, especially in older adults, stemming from the presence of multiple comorbid illnesses with confounding symptoms. New diagnostic tools have resulted in guidelines proposed to define and diagnose HFPEF. Recent literature focusing on the pathophysiology underlying this disease suggests multiple mechanisms are involved in the generation of the phenotype, such as abnormal relaxation and ventricular-vascular coupling, chronotropic incompetence, volume overload, and redistribution and /or endothelial dysfunction. Currently, no clinically proven treatments are shown to decrease morbidity and mortality in this population; however, there may be a novel multidisciplinary and multistage treatment strategy that can be studied to address this complex disease which incorporates pharmacologic and non-pharmacologic therapeutics.