Rakisheva Amina, Soloveva Anzhela, Shchendrygina Anastasia, Giverts Ilya
City Cardiology Center, Almaty, Kazakhstan.
Department of Cardiology, Almazov Almazov National Medical Research Centre, Saint Petersburg, Russia.
Int J Heart Fail. 2024 Jun 21;6(3):93-106. doi: 10.36628/ijhf.2023.0064. eCollection 2024 Jul.
Being commonly diagnosed in elderly women and associated with comorbidities as well as ageing-related cardio-vascular changes, heart failure with preserved ejection fraction (HFpEF) has been recently considered as a distinct cardiogeriatric syndrome. Frailty is another frequent geriatric syndrome. HFpEF and frailty share common underlying mechanisms, often co-exist, and represent each other's risk factors. A threshold of 65 years old is usually used to screen patients for both frailty and HFpEF in research and clinical settings. However, both HFpEF and frailty are very heterogenous conditions that may develop at younger ages. In this review we aim to provide a broader overview on the coexistence of HFpEF and frailty throughout the lifetime. We hypothesize that HFpEF and frailty patients' profiles (young, elderly, superaged) represent a continuum of the common ageing process modified by cumulative exposure to risk factors resulting to a presentation of HFpEF and frailty at different ages. We believe, that suggested approach might stimulate assessment of frailty in HFpEF assessment and vice versa regardless of age and early implementation of targeted interventions. Future studies of pathophysiology, clinical features, and outcomes of frailty in HFpEF by age are needed.
射血分数保留的心力衰竭（HFpEF）通常在老年女性中被诊断出来，并且与合并症以及与衰老相关的心血管变化有关，最近被认为是一种独特的心脏老年综合征。衰弱是另一种常见的老年综合征。HFpEF和衰弱有共同的潜在机制，经常共存，并且互为风险因素。在研究和临床环境中，通常使用65岁的阈值来筛查衰弱和HFpEF患者。然而，HFpEF和衰弱都是非常异质性的情况，可能在较年轻的年龄就会出现。在这篇综述中，我们旨在更全面地概述HFpEF和衰弱在整个生命周期中的共存情况。我们假设，HFpEF和衰弱患者的特征（年轻、老年、超高龄）代表了一个共同衰老过程的连续体，该过程因累积暴露于风险因素而改变，导致在不同年龄出现HFpEF和衰弱。我们认为，所建议的方法可能会促进在HFpEF评估中对衰弱的评估，反之亦然，而不考虑年龄，并促进有针对性干预措施的早期实施。未来需要针对不同年龄的HFpEF患者中衰弱的病理生理学、临床特征和结局进行研究。
