Senthong Vichai, Kirsop Jennifer L, Tang W H Wilson
Department of Cardiovascular Medicine, Heart and Vascular Institute, 9500 Euclid Avenue, Desk J3-4, Cleveland, OH, 44915, USA.
Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Curr Heart Fail Rep. 2017 Apr;14(2):106-116. doi: 10.1007/s11897-017-0321-4.
Heart failure (HF) is a complex clinical syndrome with diverse risk factors and etiologies, differing underlying pathophysiology, and large phenotypic heterogeneity.
Advances in imaging techniques coupled with clinical trials that targeted only in those with impaired left ventricular ejection fraction (LVEF) have largely shaped the current management strategy for HF that focuses predominantly in patients with systolic HF. In contrast, there are no effective treatments for HF with preserved ejection fraction (HFpEF). Instead of this "one-size-fits-all" approach to treatment, better precision to define HF phenotypic classifications may lead to more efficient and effective HF disease management.
Integrating variables-including clinical variables, HF biomarkers, imaging, genotypes, metabolomics, and proteomics-can identify different pathophysiologies, lead to more precise phenotypic classification, and warrant investigation in future clinical trials.
心力衰竭（HF）是一种复杂的临床综合征，具有多种危险因素和病因，潜在的病理生理学不同，且表型异质性大。
成像技术的进步以及仅针对左心室射血分数（LVEF）受损患者的临床试验，在很大程度上塑造了当前HF的管理策略，该策略主要侧重于收缩性HF患者。相比之下，射血分数保留的心力衰竭（HFpEF）尚无有效治疗方法。摒弃这种“一刀切”的治疗方法，更精确地定义HF表型分类可能会带来更高效的HF疾病管理。
整合包括临床变量、HF生物标志物、成像、基因型、代谢组学和蛋白质组学在内的变量，可以识别不同的病理生理学，实现更精确的表型分类，并值得在未来的临床试验中进行研究。
