Gori Mauro, D'Elia Emilia, Zambelli Giulia, Senni Michele
U.O.C. Cardiologia, Dipartimento Cardiovascolare, ASST Papa Giovanni XXIII, Bergamo.
G Ital Cardiol (Rome). 2020 Feb;21(2):119-127. doi: 10.1714/3300.32705.
Heart failure with preserved ejection fraction (≥50%, HFpEF) has a high prevalence, affecting approximately 50% of patients with heart failure, for which no effective medication exists as yet, as no drug therapy was successful in improving survival. HFpEF is a syndrome that in its classical form is associated with multiple risk factors and comorbidities, which confer an extreme heterogeneity characterizing HFpEF. In addition to the clinical presentation, also the pathophysiological mechanisms are multiple. Altogether, these aspects largely account for the diagnostic challenges and the lack of a comprehensive treatment strategy in HFpEF patients. A more personalized medicine approach is therefore needed, aimed at treating specific patient subsets, with therapies that in several HFpEF phenotypes proved to be effective in reducing morbidity and improving surrogate outcomes, including quality of life.
射血分数保留的心力衰竭（≥50%，HFpEF）患病率很高，约占心力衰竭患者的50%，目前尚无有效的药物治疗，因为没有药物治疗能成功改善生存率。HFpEF是一种综合征，其典型形式与多种危险因素和合并症相关，这些因素导致HFpEF具有极端的异质性。除临床表现外，病理生理机制也多种多样。总之，这些方面在很大程度上导致了HFpEF患者的诊断挑战和缺乏全面的治疗策略。因此，需要一种更个性化的医学方法，旨在治疗特定的患者亚组，采用在几种HFpEF表型中已证明能有效降低发病率和改善替代结局（包括生活质量）的疗法。
