摘要
有保存喷射部分(HFpEF ) 的心失败(HF ) 是在更老的成年人的 HF 的最普通的形式，并且当人口变老，在流行正在增加。而且， HFpEF 正在增加与 HF 与不成比例当 HFrEF 的正在改善时，减少的 EF (HFrEF ) ，和它的预后正在变得更坏。尽管有 HFpEF 的重要性，我们它的 pathophysiology 的理解不完全、最佳治疗仍然保持大部分未定义。HFpEF 的一个最重要的特征是减少的锻练忍耐，它象生活的减少的质量一样与症状相关。锻练限制的传统的概念集中了于与差的心脏的泵功能有关的中央机能障碍。然而，机制不对心和肺独占，并且这疾病的 pathophysiology 的理解演变。实质的注意集中了于定义与 HF 在病人之中位于减少的功能的能力和锻练忍耐下面的中央对外部的机制。事实上，物理训练能甚至当有利中央血液动力学的功能不在时经由外部适应机制改进锻练忍耐。另外，药试用在集中了于影响心血管的功能的 HFpEF 表现了到日期没改进锻练能力。这建议外部限制可以在限制锻练忍耐的 HF 起一个重要作用， HFpEF 的一个特点特征。
Heart failure （HF） with preserved ejection fraction （HFpEF） is the most common form of HF in older adults, and is increasing in preva- lence as the population ages. Furthermore, HFpEF is increasing out of proportion to HF with reduced EF （HFrEF）, and its prognosis is worsening while that of HFrEF is improving. Despite the importance of HFpEF, our understanding of its pathophysiology is incomplete, and optimal treatment remains largely undefined. A cardinal feature of HFpEF is reduced exercise tolerance, which correlates with symptoms as well as reduced quality of life. The traditional concepts of exercise limitations have focused on central dysfimction related to poor cardiac pump function. However, the mechanisms are not exclusive to the heart and lungs, and the understanding of the pathophysiology of this dis- ease has evolved. Substantial attention has focused on defining the central versus peripheral mechanisms underlying the reduced functional capacity and exercise tolerance among patients with HF. In fact, physical training can improve exercise tolerance via peripheral adaptive mechanisms even in the absence of favorable central hemodynamic function. In addition, the drug trials performed to date in HFpEF that have focused on influencing cardiovascular function have not improved exercise capacity. This suggests that peripheral limitations may play a significant role in HF limiting exercise tolerance, a hallmark feature of HFpEF.
