Balestrieri Giulio, Limonta Raul, Ponti Enrico, Merlo Anna, Sciatti Edoardo, D'Isa Salvatore, Gori Mauro, Casu Gavino, Giannattasio Cristina, Senni Michele, D'Elia Emilia
Cardiovascular Department, ASST Papa Giovanni XXIII Bergamo, Italy.
School of Medicine and Surgery, Milano Bicocca University Milan, Italy.
Card Fail Rev. 2024 Apr 3;10:e05. doi: 10.15420/cfr.2023.13. eCollection 2024.
Heart failure with preserved ejection fraction (HFpEF) is a clinical syndrome characterised by the presence of diastolic dysfunction and elevated left ventricular filling pressure, in the setting of a left ventricular ejection fraction of at least 50%. Despite the epidemiological prevalence of HFpEF, a prompt diagnosis is challenging and many uncertainties exist. HFpEF is characterised by different phenotypes driven by various cardiac and non-cardiac comorbidities. This is probably the reason why several HFpEF clinical trials in the past did not reach strong outcomes to recommend a single therapy for this syndrome; however, this paradigm has recently changed, and the unmet clinical need for HFpEF treatment found a proper response as a result of a new class of drug, the sodium-glucose cotransporter 2 inhibitors, which beneficially act through the whole spectrum of left ventricular ejection fraction. The aim of this review was to focus on the therapeutic target of HFpEF, the role of new drugs and the potential role of new devices to manage the syndrome.
射血分数保留的心力衰竭（HFpEF）是一种临床综合征，其特征为舒张功能障碍和左心室充盈压升高，同时左心室射血分数至少为50%。尽管HFpEF在流行病学上较为普遍，但快速诊断具有挑战性，且存在许多不确定性。HFpEF具有由各种心脏和非心脏合并症驱动的不同表型。这可能就是过去几项HFpEF临床试验未能取得有力结果以推荐针对该综合征的单一疗法的原因；然而，这种模式最近发生了变化，由于一类新型药物——钠-葡萄糖协同转运蛋白2抑制剂，HFpEF治疗中未满足的临床需求得到了适当回应，这类药物通过整个左心室射血分数范围发挥有益作用。本综述的目的是关注HFpEF的治疗靶点、新药的作用以及新设备在管理该综合征方面的潜在作用。
