射血分数保留的心力衰竭的药物治疗进展

Progress in Medication of Heart Failure with Preserved Ejection Fraction

射血分数保留的心力衰竭(HFpEF)是一种临床表现异质性大、越来越受到重视的心力衰竭类型。与射血分数降低的心力衰竭(HFrEF)相比,HFpEF患者老年女性比例较高、合并症更多、病死率更高。HFpEF在心力衰竭中所占比例越来越大,已经超过HFrEF。近年来HFrEF的诊疗取得了较大进展,而HFpEF由于病理生理机制复杂、临床表型多样,其诊断和治疗尚无统一的指南推荐。近年来,在药物治疗方面,HFpEF取得了一定进展,但是改善HFpEF患者预后的循证医学证据尚不充分。

Heart failure with preserved ejection fraction(HFpEF)is a type of heart failure with heterogeneous clinical manifestations receiving more and more attention.Compared with heart failure with reduced ejection fraction(HFrEF),HFpEF patients are featured with a higher proportion of elderly women,more complications and higher mortality.The proportion of HFpEF in heart failure is increasing,which has exceeded HFrEF.In recent years,great progress has been made in the diagnosis and treatment of HFrEF.However,due to the complexity of pathophysiology and the diversity of clinical phenotypes,there is so far no unified guideline for the diagnosis and treatment of HFpEF.In recent years,some progress has been made in the drug treatment of HFpEF,however,the evidence-based medicine proof for improving the prognosis of patients with HFpEF is still not sufficient.