Department of Cardiology, Maastricht University Medical Centre , Maastricht , The Netherlands.
Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre , Maastricht , The Netherlands.
Am J Physiol Heart Circ Physiol. 2018 Dec 1;315(6):H1670-H1683. doi: 10.1152/ajpheart.00024.2018. Epub 2018 Sep 21.
The diversity in clinical phenotypes and poor understanding of the underlying pathophysiology of heart failure with preserved ejection fraction (HFpEF) is the main reason why no effective treatments have been found yet. Targeted, instead of one size fits all, treatment seems the only promising approach for treating HFpEF. To be able to design a targeted, phenotype-specific HFpEF treatment, the matrix relating clinical phenotypes and underlying pathophysiological mechanisms has to be clarified. This review discusses the opportunities for additional evaluation of the underlying pathophysiological processes, e.g., to evaluate biological phenotypes on top of clinical routine, to guide us toward a phenotype-specific HFpEF treatment. Moreover, a translational approach with matchmaking of animal models to biological HFpEF phenotypes will be a valuable step to test the effectiveness of novel, targeted interventions in HFpEF. Listen to this article's corresponding podcast at https://ajpheart.podbean.com/e/personalized-medicine-in-hfpef/ .
心力衰竭伴射血分数保留(HFpEF)的临床表型多样,其潜在病理生理学机制认识不足,这是迄今为止尚未找到有效治疗方法的主要原因。针对特定患者而非一刀切的治疗方法似乎是治疗 HFpEF 的唯一有希望的方法。为了能够设计针对特定表型的 HFpEF 治疗方法,必须阐明与临床表型和潜在病理生理机制相关的基质。本综述讨论了进一步评估潜在病理生理过程的机会,例如在临床常规之外评估生物学表型,以指导我们进行针对特定表型的 HFpEF 治疗。此外,将动物模型与生物 HFpEF 表型相匹配的转化方法将是测试新型靶向干预 HFpEF 有效性的重要步骤。在 https://ajpheart.podbean.com/e/personalized-medicine-in-hfpef/ 上收听本文的相关播客。