Abbate Antonio, Arena Ross, Abouzaki Nayef, Van Tassell Benjamin W, Canada Justin, Shah Keyur, Biondi-Zoccai Giuseppe, Voelkel Norbert F
VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA; Victoria Johnson Research Laboratories, Virginia Commonwealth University, Richmond, VA, USA.
University of Illinois Chicago, Department of Physical Therapy, Chicago, IL, USA.
Int J Cardiol. 2015 Jan 20;179:430-40. doi: 10.1016/j.ijcard.2014.11.106. Epub 2014 Nov 14.
Heart failure (HF) with preserved ejection fraction (HFpEF) is a clinical syndrome of exercise intolerance and/or congestion, in the presence of a left ventricular (LV) ejection fraction within the normal limits (i.e. LVEF>50%). Determining the presence of impaired LV relaxation and/or filling (diastolic dysfunction) in HFpEF is needed to pragmatically to distinguish it from other cardiac and non-cardiac conditions where symptoms are not due to HF. There are multiple mechanisms for diastolic dysfunction ranging from structural abnormalities to functional derangements in HFpEF yet tailored therapies are lacking. Treatments proven effective in HF with systolic dysfunction have failed to show significant benefit in patients with HFpEF, which prognosis remains poor. This review will discuss the challenges inherent to the use of diagnostic criteria for HFpEF, differential diagnosis, prognostic evaluation, and treatment, highlighting the need for more research in this field.
射血分数保留的心力衰竭（HFpEF）是一种运动不耐受和/或充血的临床综合征，此时左心室（LV）射血分数在正常范围内（即左心室射血分数>50%）。在HFpEF中，需要确定左心室舒张功能受损和/或充盈异常（舒张功能障碍）的存在，以便实际地将其与其他症状并非由HF引起的心脏和非心脏疾病区分开来。HFpEF中舒张功能障碍有多种机制，从结构异常到功能紊乱，但缺乏针对性的治疗方法。在射血分数降低的心力衰竭中被证明有效的治疗方法，在HFpEF患者中未能显示出显著益处，其预后仍然很差。本综述将讨论HFpEF诊断标准的使用、鉴别诊断、预后评估和治疗所固有的挑战，强调该领域需要更多研究。
