Department of Internal Medicine, University of Arizona College of Medicine, Tucson, AZ 85724, USA.
Division of Cardiology, Sarver Heart Center, University of Arizona College of Medicine, Tucson, AZ 85724, USA.
Rev Cardiovasc Med. 2021 Mar 30;22(1):11-24. doi: 10.31083/j.rcm.2021.01.134.
Heart failure with preserved ejection fraction (HFpEF) is increasingly prevalent and represents more than half of all heart failure cases. It is defined by the presence of heart failure signs and symptoms, identification of cardiac structural abnormalities leading to high left ventricular filling pressures, and an EF > 50%. Common imaging findings in HFpEF include left ventricular hypertrophy, diastolic dysfunction, left atrial enlargement, and elevated pulmonary artery pressure (> 35 mm Hg). Echocardiography is the primary imaging modality for diagnosing HFpEF. It can be complemented by cardiac magnetic resonance (CMR) when further characterization is needed. Advances like real-time 3-dimensional echocardiography and speckle-tracking derived strain, as well as tissue characterization by CMR, have furthered our understanding of the mechanisms and aided in making the diagnosis of a diverse group of conditions that can present as HFpEF. This review aims to touch upon the imaging methods of characterizing HFpEF and discuss their role in specific disease entities.
射血分数保留的心力衰竭（HFpEF）日益普遍，占心力衰竭病例的一半以上。它的定义是存在心力衰竭的体征和症状，识别导致左心室充盈压升高的心脏结构异常，以及 EF>50%。HFpEF 的常见影像学表现包括左心室肥厚、舒张功能障碍、左心房增大和肺动脉压升高（>35mmHg）。超声心动图是诊断 HFpEF 的主要影像学方法。当需要进一步特征描述时，可以补充心脏磁共振（CMR）。实时三维超声心动图和斑点追踪衍生应变等进展，以及 CMR 的组织特征化，进一步加深了我们对机制的理解，并有助于诊断可能表现为 HFpEF 的各种病症。本综述旨在探讨 HFpEF 的影像学特征方法，并讨论它们在特定疾病实体中的作用。
