Ogawa Tetsuya, Koeda Misato, Nitta Kosaku
Department of Medicine, Medical Center East and Kidney Center, Tokyo Women's Medical University, Tokyo, Japan.
Ther Apher Dial. 2015 Oct;19(5):427-35. doi: 10.1111/1744-9987.12301. Epub 2015 Apr 27.
Diastolic dysfunction is frequently observed in end-stage kidney disease (ESKD), and ESKD patients have many risk factors for heart failure (HF), including hypertension, diabetes, and coronary artery disease. Diastolic HF, also called HF with preserved ejection fraction, refers to a clinical syndrome in which patients have symptoms and signs of HF, normal or near normal left ventricular (LV) systolic function, and evidence of diastolic dysfunction manifested by abnormal LV filling and elevated filling pressure. Recent reports suggest that HF with preserved ejection fraction is more common in hemodialysis patients than HF with low ejection fraction. Diastolic HF in ESKD patients is a strong predictor of death. In this article, we review the information available in the literature on the pathogenesis, diagnosis, and potential treatment strategies of diastolic dysfunction or diastolic HF based on evidence obtained in the general population that is potentially applicable to ESKD patients.
舒张功能障碍在终末期肾病（ESKD）中很常见，ESKD患者有许多心力衰竭（HF）的危险因素，包括高血压、糖尿病和冠状动脉疾病。舒张性心力衰竭，也称为射血分数保留的心力衰竭，是指一种临床综合征，患者有心力衰竭的症状和体征，左心室（LV）收缩功能正常或接近正常，且存在舒张功能障碍的证据，表现为左心室充盈异常和充盈压升高。最近的报告表明，射血分数保留的心力衰竭在血液透析患者中比射血分数低的心力衰竭更常见。ESKD患者的舒张性心力衰竭是死亡的有力预测指标。在本文中，我们根据在一般人群中获得的、可能适用于ESKD患者的证据，综述了文献中关于舒张功能障碍或舒张性心力衰竭的发病机制、诊断和潜在治疗策略的可用信息。
