Department of Cardiovascular and Thoracic Sciences, Catholic University of the Sacred Heart, Rome, Italy.
Department of Kinesiology & Health Sciences, College of Humanities & Sciences, Virginia Commonwealth University, Richmond, VA, USA.
Prog Cardiovasc Dis. 2020 Sep-Oct;63(5):570-584. doi: 10.1016/j.pcad.2020.04.011. Epub 2020 May 5.
Over the last several decades, clinicians and clinical scientists have had growing interest in heart failure (HF) diagnosis and treatment. While HF with reduced ejection fraction (EF) is a well-known clinical entity with several therapeutic strategies proven to be successful, HF with preserved ejection fraction is a more heterogenous syndrome with a prevalence that has increased in the last two decades, without effective therapeutic strategies. Great strides have been made in the detection of predisposing risk factors and pathological mechanisms; however, pharmacological therapies have shown to be ineffective in reducing cardiovascular mortality in the HF with preserved EF (HFpEF) population, opening the way to the necessity of developing new precision medicine based approaches. On the other hand, novel therapies and device interventions still require refinements with the ultimate goal of offering new clinically treatments for the HFpEF population. The aim of the present review is to provide insights into the HFpEF pathophysiology, diagnostic pathways and the latest updates on treatment strategies and their potential future application in routine clinical practice.
在过去的几十年里，临床医生和临床科学家对心力衰竭 (HF) 的诊断和治疗越来越感兴趣。虽然射血分数降低的心力衰竭 (HF) 是一种众所周知的临床实体，有几种已被证明成功的治疗策略，但射血分数保留的心力衰竭是一种更为异质的综合征，其患病率在过去二十年中有所增加，却没有有效的治疗策略。在发现易患风险因素和病理机制方面已经取得了巨大进展；然而，在射血分数保留的心力衰竭 (HFpEF) 人群中，药物治疗已被证明不能降低心血管死亡率，这就需要开发新的基于精准医学的方法。另一方面，新型治疗方法和设备干预措施仍需要改进，最终目标是为 HFpEF 人群提供新的临床治疗方法。本综述的目的是深入了解 HFpEF 的病理生理学、诊断途径以及治疗策略的最新进展及其在常规临床实践中的潜在未来应用。
