Columbia University Irving Medical Center/NewYork-Presbyterian Hospital, New York, New York, USA.
Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
J Am Coll Cardiol. 2024 Jul 9;84(2):195-212. doi: 10.1016/j.jacc.2024.04.047.
Heart failure with preserved ejection fraction (HFpEF) is associated with high morbidity and mortality. Important risk factors for the development of HFpEF are similar to risk factors for the progression of tricuspid regurgitation (TR), and both conditions frequently coexist and thus is a distinct phenotype or a marker for advanced HF. Many patients with severe, symptomatic atrial secondary TR have been enrolled in current transcatheter device trials, and may represent patients at an advanced stage of HFpEF. Management of HFpEF thus may affect the pathophysiology of TR, and the physiologic changes that occur following transcatheter treatment of TR, may also impact symptoms and outcomes in patients with HFpEF. This review discusses these issues and suggests possible management strategies for these patients.
射血分数保留的心力衰竭(HFpEF)与高发病率和死亡率相关。HFpEF 发展的重要危险因素与三尖瓣反流(TR)进展的危险因素相似,而且这两种情况经常同时存在,因此是一种明显的表型或晚期 HF 的标志物。许多患有严重、有症状的继发性三尖瓣重度反流的患者已被纳入目前的经导管器械试验,可能代表 HFpEF 的晚期患者。HFpEF 的治疗可能会影响 TR 的病理生理学,而经导管治疗 TR 后发生的生理变化也可能影响 HFpEF 患者的症状和结局。这篇综述讨论了这些问题,并为这些患者提出了可能的管理策略。