Division of Cardiology, Korea University Anam Hospital, Seoul, Korea.
Korean J Intern Med. 2020 May;35(3):514-534. doi: 10.3904/kjim.2020.104. Epub 2020 Apr 29.
Heart failure (HF) with preserved ejection fraction (HFpEF) accounts for nearly half of the cases of HF and its incidence might be increasing with the aging society. Patients with HFpEF present with significant symptoms, including exercise intolerance, impaired quality of life, and have a poor prognosis as well as frequent hospitalization and increased mortality compared with HF with reduced ejection fraction. The concept of HFpEF is still evolving and may be a virtual complex rather than a real systemic disorder. Thus, beyond solely targeting cardiac abnormalities management strategies need to be extended, such as left ventricular diastolic dysfunction. In this review, we examine new diagnostic algorithms, pathophysiology, current management status, and ongoing trials based on heterogeneous pathophysiology and etiology in HFpEF.
射血分数保留的心力衰竭（HFpEF）占心力衰竭病例的近一半，随着老龄化社会的到来，其发病率可能会增加。HFpEF 患者有明显的症状，包括运动不耐受、生活质量受损，与射血分数降低的心力衰竭患者相比，预后较差，住院频率更高，死亡率也更高。HFpEF 的概念仍在不断发展，它可能是一种虚拟的复杂疾病，而不是真正的系统性疾病。因此，除了单纯针对心脏异常进行治疗外，还需要扩展管理策略，如左心室舒张功能障碍。在这篇综述中，我们根据 HFpEF 异质性的病理生理学和病因，检查了新的诊断算法、病理生理学、当前的管理现状和正在进行的试验。
