Desai Akshay, Fang James C
Brigham and Women's Hospital, Boston, MA 02115, USA.
Heart Fail Clin. 2008 Jan;4(1):87-97. doi: 10.1016/j.hfc.2007.11.001.
The detailed pathophysiology of heart failure with preserved ejection fraction (HF-PEF) remains an area of active research and controversy; however, abnormalities of diastolic function are generally believed to play an important role. Most commonly, diastolic dysfunction occurs as a consequence of myocyte hypertrophy, endomyocardial fibrosis, and abnormalities of intracellular calcium handling that are related to normal myocardial aging and accelerated by comorbidities such as hypertension, diabetes, coronary artery disease, and obesity. In this article, three fundamental risk factors are considered for "secondary" diastolic dysfunction and HF-hypertension, diabetes, and obesity-with an emphasis on the clinical epidemiology, pathophysiologic mechanisms, and treatment implications of each. The article concludes with a brief discussion of "primary" diastolic HF due to infiltrative or restrictive cardiomyopathies.
射血分数保留的心力衰竭（HF-PEF）的详细病理生理学仍是一个积极研究且存在争议的领域；然而，舒张功能异常通常被认为起着重要作用。最常见的情况是，舒张功能障碍是心肌细胞肥大、心内膜下纤维化以及细胞内钙处理异常的结果，这些与正常心肌老化有关，并因高血压、糖尿病、冠状动脉疾病和肥胖等合并症而加速。在本文中，我们考虑了导致“继发性”舒张功能障碍和HF的三个基本风险因素——高血压、糖尿病和肥胖——重点关注每种因素的临床流行病学、病理生理机制及治疗意义。文章最后简要讨论了由浸润性或限制性心肌病引起的“原发性”舒张性心力衰竭。
