Brouwers Frank P, Hillege Hans L, van Gilst Wiek H, van Veldhuisen Dirk J
Department of Cardiology, University Medical Center Groningen, University of Groningen, Hanzeplein, Groningen, The Netherlands.
Curr Heart Fail Rep. 2012 Dec;9(4):363-8. doi: 10.1007/s11897-012-0115-7.
The incidence and prevalence of heart failure is increasing, especially heart failure with preserved ejection fraction (HFpEF) relative to heart failure with reduced ejection fraction (HFrEF). For both HFrEF and HFpEF, there is need to shift our focus from secondary to primary prevention. Detailed epidemiologic data on both HFpEF and HFrEF are needed to allow early identification of at-risk subjects. Current cohorts with new onset heart failure lack uniformity with respect to diagnosis, follow-up, and population characteristics, but most important, fail to distinguish between HFpEF and HFrEF. Studies on prevalent heart failure show ischemic heart disease as the predominant risk factor for HFrEF, while hypertension, atrial fibrillation, and diabetes are risk factors for HFpEF. As it becomes increasingly clear that both subtypes of heart failure are different syndromes, new cohorts and trials are necessary to obtain separate data on both subtypes of heart failure.
心力衰竭的发病率和患病率正在上升，尤其是射血分数保留的心力衰竭（HFpEF）相对于射血分数降低的心力衰竭（HFrEF）。对于HFrEF和HFpEF，都需要将我们的重点从二级预防转向一级预防。需要有关HFpEF和HFrEF的详细流行病学数据，以便早期识别高危人群。目前新发心力衰竭的队列在诊断、随访和人群特征方面缺乏一致性，但最重要的是，未能区分HFpEF和HFrEF。关于现患心力衰竭的研究表明，缺血性心脏病是HFrEF的主要危险因素，而高血压、心房颤动和糖尿病是HFpEF的危险因素。由于越来越清楚地认识到心力衰竭的这两种亚型是不同的综合征，因此有必要开展新的队列研究和试验，以获取关于心力衰竭这两种亚型的单独数据。
