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射血分数保留的心力衰竭患者表型分析以指导治疗决策。心力衰竭协会、欧洲心脏病学会的欧洲心律协会和欧洲高血压学会的科学声明。

Patient phenotype profiling in heart failure with preserved ejection fraction to guide therapeutic decision making. A scientific statement of the Heart Failure Association, the European Heart Rhythm Association of the European Society of Cardiology, and the European Society of Hypertension.

机构信息

Department of Cardiology, Deutsches Herzzentrum der Charité (Campus CVK), Berlin Institute of Health Center for Regenerative Therapies (BCRT), and German Centre for Cardiovascular Research (DZHK) partner site Berlin, Charité Universitätsmedizin, Berlin, Germany.

Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA.

出版信息

Eur J Heart Fail. 2023 Jul;25(7):936-955. doi: 10.1002/ejhf.2894. Epub 2023 Jul 17.

Abstract

Heart failure with preserved ejection fraction (HFpEF) represents a highly heterogeneous clinical syndrome affected in its development and progression by many comorbidities. The left ventricular diastolic dysfunction may be a manifestation of various combinations of cardiovascular, metabolic, pulmonary, renal, and geriatric conditions. Thus, in addition to treatment with sodium-glucose cotransporter 2 inhibitors in all patients, the most effective method of improving clinical outcomes may be therapy tailored to each patient's clinical profile. To better outline a phenotype-based approach for the treatment of HFpEF, in this joint position paper, the Heart Failure Association of the European Society of Cardiology, the European Heart Rhythm Association and the European Hypertension Society, have developed an algorithm to identify the most common HFpEF phenotypes and identify the evidence-based treatment strategy for each, while taking into account the complexities of multiple comorbidities and polypharmacy.

摘要

射血分数保留的心力衰竭(HFpEF)代表一种高度异质性的临床综合征,其发生和发展受到许多合并症的影响。左心室舒张功能障碍可能是心血管、代谢、肺部、肾脏和老年疾病各种组合的表现。因此,除了所有患者均使用钠-葡萄糖共转运蛋白 2 抑制剂治疗外,改善临床结局的最有效方法可能是根据每个患者的临床特征量身定制的治疗方法。为了更好地概述基于表型的 HFpEF 治疗方法,在这份联合立场文件中,欧洲心脏病学会心力衰竭协会、欧洲心律协会和欧洲高血压学会制定了一个算法,以确定最常见的 HFpEF 表型,并确定针对每种表型的基于证据的治疗策略,同时考虑到多种合并症和多种药物治疗的复杂性。

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