Key Laboratory of Birth Defects and Related Diseases of Women and Children of MOE, National Health Commission Key Laboratory of Chronobiology, Development and Related Diseases of Women and Children Key Laboratory of Sichuan Province, Children's Medicine Key Laboratory of Sichuan Province, State Key Laboratory of Biotherapy, West China Second University Hospital, Sichuan University, No.2222 Xinchuan Road, Chengdu 610041, China; Department of Cardiology and Laboratory of Cardiovascular Diseases, Institute of Cardiovascular Diseases, West China Hospital, Sichuan University, Chengdu 610041, China; West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children of MOE, National Health Commission Key Laboratory of Chronobiology, Development and Related Diseases of Women and Children Key Laboratory of Sichuan Province, Children's Medicine Key Laboratory of Sichuan Province, State Key Laboratory of Biotherapy, West China Second University Hospital, Sichuan University, No.2222 Xinchuan Road, Chengdu 610041, China; West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China.
Ageing Res Rev. 2024 Nov;101:102542. doi: 10.1016/j.arr.2024.102542. Epub 2024 Oct 12.
Heart failure with preserved ejection fraction (HFpEF) accounts for 50 % of heart failure (HF) cases, making it the most common type of HF, and its prevalence continues to increase in the aging society. HFpEF is a systemic syndrome resulting from many risk factors, such as aging, metabolic syndrome, and hypertension, and its clinical features are highly heterogeneous in different populations. HFpEF syndrome involves the dysfunction of multiple organs, including the heart, lung, muscle, and vascular system. The heart shows dysfunction of various cells, including cardiomyocytes, endothelial cells, fibroblasts, adipocytes, and immune cells. The complex etiology and pathobiology limit experimental research on HFpEF in animal models, delaying a comprehensive understanding of the mechanisms and making treatment difficult. Recently, many scientists and cardiologists have attempted to improve the clinical outcomes of HFpEF. Recent advances in clinically related animal models and systemic pathology studies have improved our understanding of HFpEF, and clinical trials involving sodium-glucose cotransporter 2 inhibitors have significantly enhanced our confidence in treating HFpEF. This review provides an updated comprehensive discussion of the etiology and pathobiology, molecular and cellular mechanisms, preclinical animal models, and therapeutic trials in animals and patients to enhance our understanding of HFpEF and improve clinical outcomes.
射血分数保留的心力衰竭（HFpEF）占心力衰竭（HF）病例的 50%，是最常见的心力衰竭类型，在老龄化社会中其患病率持续增加。HFpEF 是一种由多种危险因素引起的全身性综合征，如衰老、代谢综合征和高血压，其临床特征在不同人群中高度异质。HFpEF 综合征涉及多个器官的功能障碍，包括心脏、肺、肌肉和血管系统。心脏表现出多种细胞的功能障碍，包括心肌细胞、内皮细胞、成纤维细胞、脂肪细胞和免疫细胞。复杂的病因和病理生物学限制了动物模型中对 HFpEF 的实验研究，延缓了对其机制的全面理解，使治疗变得困难。最近，许多科学家和心脏病专家试图改善 HFpEF 的临床结局。与临床相关的动物模型和系统病理学研究的最新进展提高了我们对 HFpEF 的理解，涉及钠-葡萄糖共转运蛋白 2 抑制剂的临床试验极大地增强了我们治疗 HFpEF 的信心。本综述提供了对 HFpEF 的病因和病理生物学、分子和细胞机制、临床前动物模型以及动物和患者治疗试验的最新全面讨论，以增强我们对 HFpEF 的理解并改善临床结局。
