Oktay A Afşin, Rich Jonathan D, Shah Sanjiv J
Curr Heart Fail Rep. 2013 Dec;10(4):401-10. doi: 10.1007/s11897-013-0155-7.
Heart failure with preserved ejection fraction (HFpEF), which currently represents approximately 50 % of heart failure (HF) cases, is common and associated with high morbidity and mortality. Understanding the epidemiology of HFpEF has been difficult due to the challenges in HFpEF diagnosis and the heterogeneous etiologies and pathophysiologies that underlie HFpEF. Nevertheless, several high-quality epidemiology and observational registry studies of HFpEF demonstrate that an increasing prevalence of HFpEF in both the outpatient and inpatient settings, coupled with a lack of evidence-based effective treatments for HFpEF, is resulting in an emerging epidemic of HFpEF. In this review, we discuss the emerging HFpEF epidemic, focusing on: (1) reasons for the rising prevalence of HFpEF; (2) the abnormalities in cardiac structure and function that dictate the transition from risk factors to HFpEF; (3) novel HFpEF mechanisms that may underlie the increase in HFpEF prevalence; (4) prognosis of HFpEF; and (5) risk prediction in HFpEF. We conclude with 10 unanswered questions onHFpEF epidemiology thatwill be important areas for future investigation.
射血分数保留的心力衰竭（HFpEF）目前约占心力衰竭（HF）病例的50%，较为常见，且与高发病率和高死亡率相关。由于HFpEF诊断存在挑战，以及构成HFpEF的病因和病理生理学具有异质性，了解HFpEF的流行病学一直很困难。尽管如此，几项关于HFpEF的高质量流行病学和观察性登记研究表明，门诊和住院患者中HFpEF的患病率不断上升，再加上缺乏针对HFpEF的循证有效治疗方法，正导致HFpEF成为一种新的流行病。在本综述中，我们讨论了新出现的HFpEF流行病，重点关注：（1）HFpEF患病率上升的原因；（2）决定从危险因素转变为HFpEF的心脏结构和功能异常；（3）可能是HFpEF患病率增加基础的新HFpEF机制；（4）HFpEF的预后；以及（5）HFpEF中的风险预测。我们最后提出了10个关于HFpEF流行病学的未解决问题，这些问题将是未来研究的重要领域。
