Department of Cardiovascular Disease, Division of Circulatory Failure, Mayo Clinic, Rochester, Minnesota 55905; email:
Annu Rev Med. 2018 Jan 29;69:65-79. doi: 10.1146/annurev-med-041316-090654.
Heart failure (HF) is a clinical syndrome of diverse etiologies and can be associated with preserved, reduced, or mid-range ejection fraction (EF). In the community, heart failure with preserved ejection fraction (HFpEF) is emerging as the most common form of HF. There remains considerable uncertainty regarding its pathogenesis, diagnosis, and optimal therapeutic approach. Hypotheses have been advanced to explain the underlying pathophysiology responsible for HFpEF, but to date, no specific therapy based on these hypotheses has been proven to improve outcomes in HFpEF. We provide a clinically focused review of the epidemiology, clinical presentation, diagnostic approach, pathophysiology, and treatment of HFpEF.
心力衰竭(HF)是一种病因多样的临床综合征,可能伴有射血分数保留、降低或中间范围(EF)。在社区中,射血分数保留的心力衰竭(HFpEF)正在成为最常见的心力衰竭形式。关于其发病机制、诊断和最佳治疗方法仍然存在相当大的不确定性。已经提出了一些假说来解释导致 HFpEF 的潜在病理生理学,但迄今为止,没有基于这些假说的特定疗法被证明能改善 HFpEF 的预后。我们提供了 HFpEF 的流行病学、临床表现、诊断方法、病理生理学和治疗的临床重点综述。