Department of Internal Medicine.
Division of Cardiology, Duke University School of Medicine; Duke Clinical Research Institute, Durham, North Carolina.
J Card Fail. 2021 Sep;27(9):1002-1016. doi: 10.1016/j.cardfail.2021.04.013. Epub 2021 May 12.
Heart failure with preserved ejection fraction (HFpEF) is increasingly prevalent, yet interventions and therapies to improve outcomes remain limited. There has been increasing attention towards the impact of comorbidities and physical functioning (PF) on poor clinical outcomes within this population. In this review, we summarize and discuss the literature on PF in HFpEF, its association with clinical and patient-centered outcomes, and future advances in the care of HFpEF with respect to PF. Multiple PF metrics have been demonstrated to provide prognostic value within HFpEF, yet the data are less robust compared with other patient populations, highlighting the need for further investigation. The evaluation and detection of poor PF provides a potential strategy to improve care in HFpEF, and future studies are needed to understand if modulating PF improves clinical and/or patient-reported outcomes. LAY SUMMARY: • Patients with heart failure with preserved ejection fraction (HFpEF) commonly have impaired physical functioning (PF) demonstrated by limitations across a wide range of common PF metrics.• Impaired PF metrics demonstrate prognostic value for both clinical and patient-reported outcomes in HFpEF, making them plausible therapeutic targets to improve outcomes.• Clinical trials are ongoing to investigate novel methods of detecting, monitoring, and improving impaired PF to enhance HFpEF care.Heart failure with preserved ejection fraction (HFpEF) is increasingly prevalent, yet interventions and therapies to improve outcomes remain limited. As such, there has been increasing focus on the impact of physical performance (PF) on clinical and patient-centered outcomes. In this review, we discuss the state of PF in patients with HFpEF by examining the multitude of PF metrics available, their respective strengths and limitations, and their associations with outcomes in HFpEF. We highlight future advances in the care of HFpEF with respect to PF, particularly regarding the evaluation and detection of poor PF.
射血分数保留型心力衰竭（HFpEF）的发病率日益增高，但改善预后的干预措施和治疗方法仍然有限。因此，人们越来越关注身体机能（PF）对临床和患者为中心结局的影响。在这篇综述中，我们通过检查现有的多种 PF 指标及其各自的优缺点及其与 HFpEF 结局的相关性，来探讨 HFpEF 患者的 PF 状况。我们还重点介绍了 HFpEF 患者 PF 护理方面的未来进展，特别是在评估和检测较差的 PF 方面。
