Becher Peter Moritz, Lindner Diana, Fluschnik Nina, Blankenberg Stefan, Westermann Dirk
University Heart Center Hamburg Eppendorf, Department of General and Interventional Cardiology , Martinistraße 52, 20246 Hamburg, Germany.
Expert Opin Med Diagn. 2013 Sep;7(5):463-74. doi: 10.1517/17530059.2013.825246. Epub 2013 Aug 9.
Heart failure with preserved ejection fraction (HFPEF) is a common syndrome, accounting for about 50% of all patients with heart failure (HF). Morbidity and mortality are similar to patients with HF with reduced ejection fraction (HFREF), yet no effective treatment has been identified in randomized clinical trials.
This article provides an overview of the available literature regarding diagnosing established HFPEF and potential new therapeutic targets for the early diagnosis of HFPEF. Vascular dysfunction, ventricular-arterial coupling, oxidative stress, extracellular matrix regulation, chronotropic incompetence, pulmonary hypertension, exercise testing and biomarkers were taken into consideration next to conventional measurements of diastolic dysfunction.
Measuring diastolic dysfunction in HFPEF is considered important in many patients. Nevertheless, today we know that other causes besides diastolic dysfunction are also involved in the pathophysiology of many HFPEF patients and need to be investigated in order to make a correct diagnosis. Therefore, further research is required to allow better and more specific diagnostic and treatment options to reduce the morbidity and mortality for this ever-expanding HF population.
射血分数保留的心力衰竭（HFpEF）是一种常见综合征，约占所有心力衰竭（HF）患者的50%。其发病率和死亡率与射血分数降低的心力衰竭（HFrEF）患者相似，但在随机临床试验中尚未确定有效的治疗方法。
本文概述了有关诊断已确诊的HFpEF的现有文献以及HFpEF早期诊断的潜在新治疗靶点。除了传统的舒张功能障碍测量方法外，还考虑了血管功能障碍、心室-动脉耦联、氧化应激、细胞外基质调节、变时性功能不全、肺动脉高压、运动试验和生物标志物。
在许多HFpEF患者中，测量舒张功能障碍被认为很重要。然而，如今我们知道，除舒张功能障碍外，其他原因也参与了许多HFpEF患者的病理生理学过程，为了做出正确诊断需要对其进行研究。因此，需要进一步研究以提供更好、更具特异性的诊断和治疗选择，从而降低这一不断扩大的HF人群的发病率和死亡率。
