Baker IDI Heart and Diabetes Institute, Melbourne, Australia; Heart Center, Alfred Hospital, Melbourne, Australia.
Int J Cardiol. 2013 Sep 30;168(2):716-22. doi: 10.1016/j.ijcard.2013.05.006. Epub 2013 May 24.
Approximately half of all patients with heart failure (HF) have a preserved left ventricular ejection fraction (HFPEF) and the prevalence of this form of HF is increasing. Although dyspnoea on exertion and diminished functional capacity is the key symptom of patients with HFPEF, current diagnostic criteria focus on resting indices of ventricular function. Specifically, current proposed criteria for the diagnosis of HFPEF, include clinical signs of HF; normal left ventricular systolic function; and evidence of abnormal diastolic performance and/or altered natriuretic peptides. By contrast, recent studies demonstrate that the key pathophysiologic features of HFPEF may not be evident at rest, and can only be detected during exertion. This review addresses the potential role of exercise testing using invasive haemodynamic or echocardiographic assessment in patients with suspected HFPEF in which current diagnostic criteria are not met.
大约一半的心衰（HF）患者具有保留的左心室射血分数（HFPEF），这种形式的心衰的患病率正在增加。虽然呼吸困难和功能能力下降是 HFPEF 患者的关键症状，但目前的诊断标准侧重于心室功能的静息指数。具体来说，目前提出的 HFPEF 诊断标准包括 HF 的临床体征；正常的左心室收缩功能；以及异常的舒张功能和/或改变的利钠肽的证据。相比之下，最近的研究表明，HFPEF 的关键病理生理特征在休息时可能不明显，只能在用力时检测到。本综述探讨了在不符合当前诊断标准的疑似 HFPEF 患者中使用侵入性血流动力学或超声心动图评估进行运动试验的潜在作用。
