Tah Sunanda, Valderrama Melissa, Afzal Maham, Iqbal Javed, Farooq Aisha, Lak Muhammad Ali, Gostomczyk Karol, Jami Elhama, Kumar Mahendra, Sundaram Akshay, Sharifa Mouhammad, Arain Mustafa
Surgery, Beckley Appalachian Regional Healthcare (ARH) Hospital, Beckley, USA.
Surgery, Saint James School of Medicine, Arnos Vale, VCT.
Cureus. 2023 Sep 28;15(9):e46152. doi: 10.7759/cureus.46152. eCollection 2023 Sep.
Heart failure (HF) with preserved ejection fraction (HFpEF) is a clinical syndrome in which patients have signs and symptoms of HF due to high left ventricular (LV) filling pressure despite normal or near normal LV ejection fraction. It is more common than HF with reduced ejection fraction (HFrEF), and its diagnosis and treatment are more challenging than HFrEF. Although hypertension is the primary risk factor, coronary artery disease and other comorbidities, such as atrial fibrillation (AF), diabetes, chronic kidney disease (CKD), and obesity, also play an essential role in its formation. This review summarizes current knowledge about HFpEF, its pathophysiology, clinical presentation, diagnostic challenges, current treatments, and promising novel treatments. It is essential to continue to be updated on the latest treatments for HFpEF so that patients always receive the most therapeutic treatments. The use of GnRH agonists in the management of HFpEF, infusion of Apo a-I nanoparticle, low-level transcutaneous vagal stimulation (LLTS), and estrogen only in post-menopausal women are promising strategies to prevent diastolic dysfunction and HFpEF; however, there is still no proven curative treatment for HFpEF yet.
射血分数保留的心力衰竭（HFpEF）是一种临床综合征，患者尽管左心室（LV）射血分数正常或接近正常，但由于左心室充盈压升高而出现心力衰竭的体征和症状。它比射血分数降低的心力衰竭（HFrEF）更常见，其诊断和治疗比HFrEF更具挑战性。虽然高血压是主要危险因素，但冠状动脉疾病和其他合并症，如心房颤动（AF）、糖尿病、慢性肾脏病（CKD）和肥胖，在其形成中也起着重要作用。本综述总结了关于HFpEF的现有知识、其病理生理学、临床表现、诊断挑战、当前治疗方法以及有前景的新治疗方法。持续更新HFpEF的最新治疗方法至关重要，以便患者始终能接受最具疗效的治疗。在HFpEF管理中使用促性腺激素释放激素（GnRH）激动剂、输注载脂蛋白A-I纳米颗粒、低强度经皮迷走神经刺激（LLTS）以及仅在绝经后女性中使用雌激素是预防舒张功能障碍和HFpEF的有前景策略；然而，目前尚无已证实的治愈HFpEF的治疗方法。
