Louridas George E, Lourida Katerina G
Department of Cardiology, University General Hospital AHEPA, Aristotle University, Thessaloniki 54124, Greece.
J Cardiovasc Dev Dis. 2016 Sep 8;3(3):27. doi: 10.3390/jcdd3030027.
Over the last two decades, important advances have been made in explaining some pathophysiological aspects of heart failure with preserved ejection fraction (HFpEF) with repercussions for the successful clinical management of the syndrome. Despite these gains, our knowledge for the natural history of clinical progression from the pre-clinical diastolic dysfunction (PDD) until the final clinical stages is significantly limited. The subclinical progression of PDD to the clinical phenotype of HFpEF and the further clinical progression to some more complex clinical models with multi-organ involvement, similar to heart failure with reduced ejection fraction (HFrEF), continue to be poorly understood. Prospective studies are needed to elucidate the natural history of clinical progression in patients with HFpEF and to identify the exact left ventricular remodeling mechanism that underlies this progression.
在过去二十年中，在解释射血分数保留的心力衰竭（HFpEF）的一些病理生理方面取得了重要进展，这对该综合征的成功临床管理产生了影响。尽管有这些进展，但我们对从临床前舒张功能障碍（PDD）到最终临床阶段的临床进展自然史的了解仍然非常有限。PDD向HFpEF临床表型的亚临床进展以及进一步向一些更复杂的多器官受累临床模型的临床进展，类似于射血分数降低的心力衰竭（HFrEF），仍然知之甚少。需要进行前瞻性研究来阐明HFpEF患者临床进展的自然史，并确定这种进展背后的确切左心室重塑机制。
