Pecoits-Filho Roberto, Bucharles Sérgio, Barberato Silvio H
Center for Health and Biological Sciences, Pontificia Universidade Católica do Paraná, Curitiba, Brazil.
Semin Dial. 2012 Jan-Feb;25(1):35-41. doi: 10.1111/j.1525-139X.2011.01011.x.
Heart failure (HF) is very common in the general population, and risk factors for HF, such as coronary artery disease, diabetes, obesity, and hypertension, are frequently present in patients with CKD. Therefore, HF is also an important cause of morbidity and mortality in this population. Diastolic heart failure (DHF), also called HF with preserved ejection fraction, refers to a clinical syndrome in which patients have symptoms and signs of HF, normal or near normal left ventricular (LV) systolic function, and evidence of diastolic dysfunction (e.g., abnormal LV filling and elevated filling pressure). Recent data suggest that HF with normal ejection fraction is even more common in patients than HF with low ejection fraction, including those on hemodialysis. Not surprisingly, DHF is a strong predictor of death in CKD patients. In this article, we review the information available on the mechanisms, clinical presentation, impact, and potential interventions in DHF based on evidence from CKD patients, as well as evidence from the general population potentially applicable to the CKD population.
心力衰竭（HF）在普通人群中非常常见，而HF的危险因素，如冠状动脉疾病、糖尿病、肥胖和高血压，在慢性肾脏病（CKD）患者中也经常存在。因此，HF也是该人群发病和死亡的重要原因。舒张性心力衰竭（DHF），也称为射血分数保留的心力衰竭，是指一种临床综合征，患者有HF的症状和体征，左心室（LV）收缩功能正常或接近正常，并有舒张功能障碍的证据（如LV充盈异常和充盈压升高）。最近的数据表明，射血分数正常的HF在患者中甚至比射血分数低的HF更常见，包括那些接受血液透析的患者。不出所料，DHF是CKD患者死亡的有力预测因素。在本文中，我们根据CKD患者的证据以及可能适用于CKD人群的普通人群的证据，综述了关于DHF的机制、临床表现、影响和潜在干预措施的现有信息。
