慢性射血分数保留心力衰竭的发病机制与诊治

Mechanisms, diagnoses and therapies of heart failure with preserved ejection fraction

左心室射血分数保留的心力衰竭(HF-p EF)在临床中较常见,处理此类心力衰竭对临床医生是一个挑战。HF-p EF的发病率和死亡率与左心室射血分数降低的心力衰竭(HF-r EF)相同,且发病机制更加复杂,既有心脏本身也有其他脏器的异常,同时还存在多种并发症间的相互作用影响。现有治疗心力衰竭的多数药物对于HFp EF无效,因此这类患者应该受到更多的关注。本文基于临床实践和基础研究,总结了HFp EF的流行病学特点、发病机制、诊断标准、医学上曾经尝试过的治疗方法,并对未来治疗本病的新手段进行讨论。

Heart failure with left ventricular ejection ~action is not common, which is named HF with preserved EF （HF-pEF）, is increasingly predominant form of HF in the real world. Its morbidity and mortality are equal with HF with reduced EF （HF-rEF） and it remains the most challenging of clinical syndromes for the practicing clinician, with a multitude of proposed mechanisms involving the heart and other organs and complex interplay with common comorbidities. As the list of failed treatments continues to grow, HF-pEF clearly represents a major unmet medical need. In this article, we provide an overview of HF-pEF for both the clinical and basic research, which includes a brief examination of its evolving epidemiology, a summary of proposed mechanisms, the diagnostic criteria, a review of our valiant but unsuccessful prior efforts to develop an effective therapy and a discussion of newer potential approaches.