Baker Carrie, Perkins Scott L, Schoenborn Erika, Biondi Nicholas L, Bowers Riley D
22357Cape Fear Valley Medical Center, Fayetteville, NC, USA.
Department of Pharmacy Practice, 15462Campbell University College of Pharmacy & Health Sciences, Buies Creek, NC, USA.
J Pharm Pract. 2023 Feb;36(1):155-163. doi: 10.1177/08971900211027315. Epub 2021 Jun 24.
Heart failure with mildly reduced ejection fraction (HFmrEF) has been classified using various definitions since its first mention in the literature in 2014. This group was most recently defined in the as HF with a left ventricular ejection fraction of 41% to 49%. An increasing emphasis has been placed on HFmrEF over the past several years, with many recent publications suggesting that common therapies used in HF with reduced ejection fraction provide benefit in this population as well. Patients with HFmrEF comprise approximately one-quarter of all patients with HF. The lack of authoritative guidance concerning pharmacotherapeutic approaches in these patients leaves a significant portion of HF patients without an evidence-based approach. Although it remains unclear if HFmrEF is simply a transitional state from preserved to reduced ejection fraction, or a distinct phenotype requiring medical optimization, there are clear cardiovascular benefits to managing this subset appropriately. This publication was created to help serve as a resource for clinicians on this evolving subset of HF and aid in preventing the progression of this disease state through improved therapy optimization. The objective of this article is to briefly discuss the epidemiology and pathophysiology of HFmrEF and review the pharmacology and clinical application of therapies for the management of HFmrEF.
自2014年首次在文献中被提及以来，射血分数轻度降低的心力衰竭（HFmrEF）一直使用各种定义进行分类。该组最近在[具体文献]中被定义为左心室射血分数为41%至49%的心力衰竭。在过去几年中，人们对HFmrEF的重视程度日益增加，最近许多出版物表明，用于射血分数降低的心力衰竭的常见疗法在这一人群中也有益处。HFmrEF患者约占所有心力衰竭患者的四分之一。对于这些患者的药物治疗方法缺乏权威性指导，导致很大一部分心力衰竭患者没有循证治疗方法。尽管目前尚不清楚HFmrEF仅仅是从射血分数保留到降低的过渡状态，还是需要进行医学优化的独特表型，但对这一亚组进行适当管理显然有心血管益处。本出版物旨在为临床医生提供有关这一不断演变的心力衰竭亚组的参考资源，并通过优化治疗帮助预防这种疾病状态的进展。本文的目的是简要讨论HFmrEF的流行病学和病理生理学，并回顾用于管理HFmrEF的治疗方法的药理学和临床应用。
