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射血分数保留的心力衰竭的当前治疗方法。

Current Treatment of Heart Failure with Preserved Ejection Fraction.

作者信息

Riccardi Mauro, D'Elia Emilia, Lombardi Carlo M, Savarese Gianluigi, Gori Mauro, Oliva Fabrizio, Volterrani Maurizio, Senni Michele, Metra Marco, Inciardi Riccardo M

机构信息

Institute of Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25121 Brescia, Italy.

Cardiology Division, ASST Cremona, 26100 Cremona, Italy.

出版信息

J Clin Med. 2025 Jul 31;14(15):5406. doi: 10.3390/jcm14155406.

Abstract

Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous syndrome with increasing prevalence and substantial morbidity and mortality. Recent advances in pharmacotherapy have transformed its management. This review summarizes current evidence supporting the use of sodium-glucose cotransporter 2 inhibitors, non-steroidal mineralocorticoid receptor antagonists, and glucagon-like peptide-1 receptor agonists, alongside selected use of angiotensin receptor-neprilysin inhibitors. Emphasis is placed on early initiation of disease-modifying therapies, phenotypic tailoring, and comorbidity-targeted strategies, especially in obese and diabetic patients. Together, these approaches define a new era of guideline-directed, personalized care for patients with HFpEF.

摘要

射血分数保留的心力衰竭(HFpEF)是一种异质性综合征,其患病率不断上升,发病率和死亡率都很高。药物治疗的最新进展改变了其治疗方式。本综述总结了支持使用钠-葡萄糖协同转运蛋白2抑制剂、非甾体盐皮质激素受体拮抗剂、胰高血糖素样肽-1受体激动剂以及选择性使用血管紧张素受体脑啡肽酶抑制剂的现有证据。重点强调尽早开始疾病修饰治疗、根据表型调整治疗方案以及针对合并症的治疗策略,尤其是在肥胖和糖尿病患者中。这些方法共同为HFpEF患者定义了一个由指南指导的个性化护理新时代。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e23e/12347804/043e8124cd31/jcm-14-05406-g001.jpg

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