Cell Signalling Research Group, School of Life Sciences, University of Nottingham, Nottingham, United Kingdom.
Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), partner site, Berlin, Germany.
J Am Coll Cardiol. 2020 Mar 10;75(9):1074-1082. doi: 10.1016/j.jacc.2019.12.049.
Heart failure (HF) is a complex condition affecting >40 million people worldwide. It is defined by failure of the heart to pump (HF with reduced ejection fraction) or by the failure of the heart to relax, resulting in reduced filling but with preserved ejection fraction (HFpEF). HFpEF affects approximately 50% of patients with HF, most of whom are women. Given that the annual mortality ranges from 10% to 30% and as there are no treatments specifically directed for HFpEF, there is a need for better understanding of the underlying mechanisms of this condition. We put forward the hypothesis that the decline of estrogen at menopause might contribute to the pathogenesis of HFpEF and we highlight potential underlying mechanisms of estrogen action, which may attenuate the development of HFpEF. We also discuss areas in which additional research is needed to develop new approaches for prevention and treatment of HFpEF.
心力衰竭(HF)是一种影响全球超过 4000 万人的复杂病症。它的定义是心脏泵血功能衰竭(射血分数降低性心力衰竭)或心脏舒张功能衰竭,导致充盈减少但射血分数保留(HFpEF)。HFpEF 影响约 50%的心力衰竭患者,其中大多数为女性。鉴于每年的死亡率在 10%至 30%之间,而且没有专门针对 HFpEF 的治疗方法,因此需要更好地了解这种病症的潜在机制。我们提出假设,即绝经后雌激素水平下降可能导致 HFpEF 的发病机制,并强调雌激素作用的潜在机制,这可能会减轻 HFpEF 的发展。我们还讨论了需要进一步研究的领域,以开发预防和治疗 HFpEF 的新方法。