Department of Translational Medical Sciences, "Federico II" University, Naples.
Monaldi Arch Chest Dis. 2021 Aug 3;92(1). doi: 10.4081/monaldi.2021.1743.
Heart failure with preserved ejection fraction (HFpEF) is a complex clinical syndrome that accounts for more than half of all heart failure patients. Identification, early diagnosis and management of patients are still complex, and no targeted treatment is available, since all tested drugs were not able to lower hard clinical outcomes. A multi-hormonal deficiency syndrome has been described in HFpEF patients suggesting that different hormones may represent new biomarkers of the disease, but their clinical utility is still debated. The natriuretic peptides are the cornerstone biomarker in heart failure, predicting cardiovascular death and heart failure hospitalization. Testosterone and DHEA-S deficiencies have been reported in HFpEF and associated with right ventricular impairment and diastolic dysfunction. IGFBP-1/IGF-1 axis correlates with echocardiographic parameters of HFpEF patients and with several prognostic biomarkers including NT-proBNP and C reactive protein. Low triiodothyronine syndrome is frequently found in HFpEF and thyroid hormones should represent a potential biomarker of risk stratification and prognosis.
射血分数保留的心力衰竭（HFpEF）是一种复杂的临床综合征，占心力衰竭患者的一半以上。患者的识别、早期诊断和管理仍然很复杂，因为所有经过测试的药物都不能降低硬临床结局。HFpEF 患者存在多种激素缺乏综合征，表明不同的激素可能代表疾病的新生物标志物，但它们的临床实用性仍存在争议。利钠肽是心力衰竭的基石生物标志物，可预测心血管死亡和心力衰竭住院。HFpEF 患者中报告有睾酮和 DHEA-S 缺乏，并与右心室损伤和舒张功能障碍相关。IGFBP-1/IGF-1 轴与 HFpEF 患者的超声心动图参数相关，与多种预后生物标志物相关，包括 NT-proBNP 和 C 反应蛋白。低三碘甲状腺原氨酸综合征在 HFpEF 中很常见，甲状腺激素应该是风险分层和预后的潜在生物标志物。
