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射血分数保留的心力衰竭的当代治疗选择。

Contemporary treatment options in heart failure with preserved ejection fraction.

机构信息

Department of Cardiology, University Heart Center Graz, Medical University of Graz, Graz, Austria.

Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.

出版信息

Eur Heart J Cardiovasc Imaging. 2024 Oct 30;25(11):1517-1524. doi: 10.1093/ehjci/jeae201.

Abstract

Heart failure with preserved ejection fraction (HFpEF) constitutes approximately half of the heart failure population, with its prevalence markedly increasing with older age and the presence of cardio-metabolic comorbidities. Although HFpEF is associated with a high symptom- and mortality burden, historically there have been few evidence-based treatment options for patients with HFpEF. Recent randomized clinical trials have expanded evidence on pharmacological treatment options, introducing new agents for managing HFpEF. Given the complex clinical phenotype with pathophysiological heterogeneity and evolving diagnostic standards, the evidence-based management of HFpEF remains challenging for clinicians. This review summarizes the latest evidence from contemporary randomized clinical trials and recent guideline recommendations to provide guidance for the treatment of patients with HFpEF.

摘要

射血分数保留的心力衰竭(HFpEF)约占心力衰竭患者的一半,其患病率随着年龄的增长和存在心脏代谢合并症而显著增加。虽然 HFpEF 与高症状和死亡率负担相关,但历史上 HFpEF 患者的治疗选择很少有循证依据。最近的随机临床试验扩大了药物治疗选择的证据,为 HFpEF 的管理引入了新的药物。鉴于具有病理生理学异质性和不断发展的诊断标准的复杂临床表型,HFpEF 的循证管理对临床医生仍然具有挑战性。本综述总结了当代随机临床试验和最近指南建议的最新证据,为 HFpEF 患者的治疗提供指导。

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