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非酒精性脂肪性肝病治疗对射血分数保留的心力衰竭的影响。

Effects of treatment of non-alcoholic fatty liver disease on heart failure with preserved ejection fraction.

作者信息

Yang Zifeng, Tian Ruifeng, Zhang Xiao-Jing, Cai Jingjing, She Zhi-Gang, Li Hongliang

机构信息

Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China.

Institute of Model Animal, Wuhan University, Wuhan, China.

出版信息

Front Cardiovasc Med. 2023 Jan 12;9:1120085. doi: 10.3389/fcvm.2022.1120085. eCollection 2022.

Abstract

In the past few decades, non-alcoholic fatty liver disease (NAFLD) and heart failure with preserved ejection fraction (HFpEF) have become the most common chronic liver disease and the main form of heart failure (HF), respectively. NAFLD is closely associated with HFpEF by sharing common risk factors and/or by boosting systemic inflammation, releasing other secretory factors, and having an expansion of epicardial adipose tissue (EAT). Therefore, the treatments of NAFLD may also affect the development and prognosis of HFpEF. However, no specific drugs for NAFLD have been approved by the Food and Drug Administration (FDA) and some non-specific treatments for NAFLD are applied in the clinic. Currently, the treatments of NAFLD can be divided into non-pharmacological and pharmacological treatments. Non-pharmacological treatments mainly include dietary intervention, weight loss by exercise, caloric restriction, and bariatric surgery. Pharmacological treatments mainly include administering statins, thiazolidinediones, glucagon-like peptide-1 receptor agonists, sodium-glucose cotransporter 2 inhibitors, and metformin. This review will mainly focus on analyzing how these treatments may affect the development and prognosis of HFpEF.

摘要

在过去几十年中,非酒精性脂肪性肝病(NAFLD)和射血分数保留的心力衰竭(HFpEF)分别成为最常见的慢性肝病和心力衰竭(HF)的主要形式。NAFLD通过共享共同危险因素和/或通过促进全身炎症、释放其他分泌因子以及使心外膜脂肪组织(EAT)扩张,与HFpEF密切相关。因此,NAFLD的治疗可能也会影响HFpEF的发生发展和预后。然而,尚无治疗NAFLD的特异性药物获得美国食品药品监督管理局(FDA)批准,临床上应用的是一些NAFLD的非特异性治疗方法。目前,NAFLD的治疗可分为非药物治疗和药物治疗。非药物治疗主要包括饮食干预、运动减肥、热量限制和减肥手术。药物治疗主要包括使用他汀类药物、噻唑烷二酮类药物、胰高血糖素样肽-1受体激动剂、钠-葡萄糖协同转运蛋白2抑制剂和二甲双胍。本综述将主要聚焦于分析这些治疗如何影响HFpEF的发生发展和预后。

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