Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA; email:
T1 Center for Cardiovascular Therapeutics, Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA.
Annu Rev Pharmacol Toxicol. 2019 Jan 6;59:41-63. doi: 10.1146/annurev-pharmtox-010818-021136. Epub 2018 Oct 8.
Heart failure with preserved ejection fraction (HFpEF) accounts for over half of prevalent heart failure (HF) worldwide, and prognosis after hospitalization for HFpEF remains poor. Due, at least in part, to the heterogeneous nature of HFpEF, drug development has proved immensely challenging. Currently, there are no universally accepted therapies that alter the clinical course of HFpEF. Despite these challenges, important mechanistic understandings of the disease have revealed that the pathophysiology of HFpEF is distinct from that of HF with reduced ejection fraction and have also highlighted potential new therapeutic targets for HFpEF. Of note, HFpEF is a systemic syndrome affecting multiple organ systems. Depending on the organ systems involved, certain novel therapies offer promise in reducing the morbidity of the HFpEF syndrome. In this review, we aim to discuss novel pharmacotherapies for HFpEF based on its unique pathophysiology and identify key research strategies to further elucidate mechanistic pathways to develop novel therapeutics in the future.
射血分数保留的心力衰竭（HFpEF）占全球心力衰竭（HF）的一半以上，HFpEF 患者住院后的预后仍然较差。由于 HFpEF 的异质性，药物开发极具挑战性。目前，尚无改变 HFpEF 临床病程的普遍接受的治疗方法。尽管面临这些挑战，但对该疾病的重要机制的理解表明，HFpEF 的病理生理学与射血分数降低的心力衰竭不同，也突出了 HFpEF 的潜在新治疗靶点。值得注意的是，HFpEF 是一种影响多个器官系统的全身性综合征。根据涉及的器官系统，某些新型疗法有望降低 HFpEF 综合征的发病率。在这篇综述中，我们旨在根据其独特的病理生理学讨论 HFpEF 的新型药物疗法，并确定关键的研究策略，以进一步阐明机制途径，为未来开发新型疗法。
