Fagerberg B
Sektionen för akutmedicin, medicin, Sahlgrenska Universitetssjukhuset/Sahlgrenska, Göteborg.
Lakartidningen. 1998 Nov 18;95(47):5305-8.
Comparison of patients treated for chronic heart failure at a large hospital with patients included in major treatment studies published during the past ten years yielded important information. The former series was characterised by greater proportions of the elderly and of women than were the series recruited to the often cited ACE (angiotensin-converting enzyme) inhibitor studies. Although only patients with systolic dysfunction were recruited to the latter studies, a substantial body of evidence suggests the prevalence of severe heart failure among patients with normal systolic function to increase with increasing age. Thus, as many as 50 per cent of all elderly patients with chronic heart failure may have normal systolic function. In most cases, the heart failure is probably due to diastolic dysfunction, a condition that still lacks both a simple diagnostic procedure and a well-documented treatment.
一家大型医院中接受慢性心力衰竭治疗的患者与过去十年发表的主要治疗研究中纳入的患者进行比较，得出了重要信息。前一组患者的特点是老年人和女性的比例高于经常被引用的ACE（血管紧张素转换酶）抑制剂研究中招募的患者组。尽管后一组研究仅招募了收缩功能障碍患者，但大量证据表明，收缩功能正常的患者中严重心力衰竭的患病率随年龄增长而增加。因此，所有老年慢性心力衰竭患者中多达50%可能收缩功能正常。在大多数情况下，心力衰竭可能是由于舒张功能障碍，这种情况仍然既缺乏简单的诊断程序，也缺乏充分记录的治疗方法。
