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射血分数保留的心力衰竭

[Heart failure with preserved left ventricular ejection fraction].

作者信息

Petutschnigg Johannes, Edelmann Frank

机构信息

Medizinische Klinik mit Schwerpunkt Kardiologie, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Deutschland.

Standort Berlin, Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Berlin, Deutschland.

出版信息

Internist (Berl). 2019 Sep;60(9):925-942. doi: 10.1007/s00108-019-0653-0.

Abstract

Heart failure remains the number one diagnosis among patients receiving inpatient treatment in Germany. Heart failure with preserved ejection fraction (HFpEF) needs to be verified by signs and symptoms of HF, echocardiographic parameters as well as cardiac biomarkers. Based on etiological and pathophysiological considerations, a classification into systolic and diastolic heart failure and later heart failure with reduced ejection fraction (HFrEF) and HFpEF was proposed. The inhomogeneous group of patients with HFpEF accounts for half of all heart failure cases in the population. Effective treatment options are limited. This article discusses which verified treatments may help or may even be harmful. A glimpse is taken into the future and those substances that are in advanced stages of clinical trials are described.

摘要

心力衰竭仍然是德国住院治疗患者的首要诊断疾病。射血分数保留的心力衰竭(HFpEF)需要通过心力衰竭的体征和症状、超声心动图参数以及心脏生物标志物来确诊。基于病因学和病理生理学的考虑,提出了收缩性和舒张性心力衰竭的分类,后来又分为射血分数降低的心力衰竭(HFrEF)和HFpEF。HFpEF患者这一异质性群体占所有心力衰竭病例的一半。有效的治疗选择有限。本文讨论了哪些已证实的治疗方法可能有帮助甚至可能有害。对未来进行了展望,并描述了处于临床试验后期阶段的药物。

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