射血分数保留型心力衰竭的流行病学。
Epidemiology of heart failure with preserved ejection fraction.
机构信息
Department of Cardiovascular Disease, Division of Circulatory Failure, Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905, USA.
Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905, USA.
出版信息
Nat Rev Cardiol. 2017 Oct;14(10):591-602. doi: 10.1038/nrcardio.2017.65. Epub 2017 May 11.
Heart failure (HF) with preserved ejection fraction (HFpEF) is a clinical syndrome associated with poor quality of life, substantial health-care resource utilization, and premature mortality. We summarize the current knowledge regarding the epidemiology of HFpEF with a focus on community-based studies relevant to quantifying the population burden of HFpEF. Current data regarding the prevalence and incidence of HFpEF in the community as well as associated conditions and risk factors, risk of morbidity and mortality after diagnosis, and quality of life are presented. In the community, approximately 50% of patients with HF have HFpEF. Although the age-specific incidence of HF is decreasing, this trend is less dramatic for HFpEF than for HF with reduced ejection fraction (HFrEF). The risk of HFpEF increases sharply with age, but hypertension, obesity, and coronary artery disease are additional risk factors. After adjusting for age and other risk factors, the risk of HFpEF is fairly similar in men and women, whereas the risk of HFrEF is much lower in women. Multimorbidity is common in both types of HF, but slightly more severe in HFpEF. A majority of deaths in patients with HFpEF are cardiovascular, but the proportion of noncardiovascular deaths is higher in HFpEF than HFrEF.
射血分数保留的心力衰竭(HFpEF)是一种与生活质量差、大量医疗保健资源利用和过早死亡相关的临床综合征。我们总结了 HFpEF 的流行病学现状,重点关注与量化 HFpEF 人群负担相关的基于社区的研究。目前关于社区中 HFpEF 的患病率和发病率,以及相关的病症和危险因素、诊断后发病率和死亡率以及生活质量的风险的相关数据。在社区中,约有 50%的心力衰竭患者患有 HFpEF。尽管特定年龄组的心力衰竭发病率在下降,但这一趋势在 HFpEF 中不如在射血分数降低的心力衰竭(HFrEF)中明显。HFpEF 的风险随着年龄的增长急剧增加,但高血压、肥胖和冠状动脉疾病是额外的危险因素。在调整年龄和其他危险因素后,HFpEF 的风险在男性和女性中相当相似,而女性的 HFrEF 风险要低得多。两种类型的心力衰竭都常见多种病症,但 HFpEF 中更严重。HFpEF 患者的大多数死亡是心血管原因,但非心血管死亡的比例在 HFpEF 中高于 HFrEF。