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射血分数保留的心力衰竭:美国心脏病学会杂志科学声明。

Heart Failure With Preserved Ejection Fraction: JACC Scientific Statement.

机构信息

Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.

Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.

出版信息

J Am Coll Cardiol. 2023 May 9;81(18):1810-1834. doi: 10.1016/j.jacc.2023.01.049. Epub 2023 Apr 19.

Abstract

The incidence and prevalence of heart failure with preserved ejection fraction (HFpEF) continue to rise in tandem with the increasing age and burdens of obesity, sedentariness, and cardiometabolic disorders. Despite recent advances in the understanding of its pathophysiological effects on the heart, lungs, and extracardiac tissues, and introduction of new, easily implemented approaches to diagnosis, HFpEF remains under-recognized in everyday practice. This under-recognition presents an even greater concern given the recent identification of highly effective pharmacologic-based and lifestyle-based treatments that can improve clinical status and reduce morbidity and mortality. HFpEF is a heterogenous syndrome and recent studies have suggested an important role for careful, pathophysiological-based phenotyping to improve patient characterization and to better individualize treatment. In this JACC Scientific Statement, we provide an in-depth and updated examination of the epidemiology, pathophysiology, diagnosis, and treatment of HFpEF.

摘要

射血分数保留的心力衰竭(HFpEF)的发病率和患病率与肥胖、久坐不动和心血管代谢疾病的日益增加的年龄和负担呈同步上升趋势。尽管人们对其对心脏、肺部和心脏外组织的病理生理影响有了新的认识,并引入了新的、易于实施的诊断方法,但 HFpEF 在日常实践中仍未得到充分认识。鉴于最近发现了一些非常有效的基于药物和生活方式的治疗方法,可以改善临床状况并降低发病率和死亡率,这种认识不足的情况更加令人担忧。HFpEF 是一种异质性综合征,最近的研究表明,仔细进行基于病理生理学的表型分析对于改善患者特征和更好地个体化治疗具有重要作用。在这份 JACC 科学声明中,我们对 HFpEF 的流行病学、病理生理学、诊断和治疗进行了深入和更新的检查。

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