射血分数保留性心力衰竭的诊断的研究进展

Diagnosis of Heart Failure with Preserved Ejection Fraction

射血分数保留性心力衰竭(HFpEF)是一种机制复杂和临床表现多样的心力衰竭,目前,其患者人数约占全部心力衰竭的一半,是常见的心力衰竭类型之一。由于HFpEF患者临床表现具有高度异质性,以及常被用来诊断心力衰竭的指标和检查(如脑钠肽和超声心动图)被发现并不具备诊断HFpEF的特异性,这使得很多HFpEF患者漏诊和误诊,从而延误了HFpEF患者的及时治疗。为了能明确HFpEF的诊断,近些年出现了HFA-PEFF和H2FPEF两种诊断评分系统。但由于对HFpEF机制认识的不足,缺乏特异性指标以及相关检查技术要求较高等原因导致HFpEF的诊断标准尚未统一。现从HFpEF的诊断要点、相关的评分系统以及研究进展等方面对HFpEF的研究进行综述。

Heart failure with preserved ejection fraction(HFpEF)is a kind of heart failure with complex mechanism and various clinical phenotypes.At present,the number of patients accounts for about half of all heart failure,which is one of the common types of heart failure.Because the clinical manifestations of HFpEF patients are highly heterogeneous,and the indexes and examinations(such as brain natriuretic peptide and echocardiography)often used to diagnose heart failure are found to be not specific for diagnosing HFpEF,many HFpEF patients are missed and misdiagnosed,thus delaying the treatment of HFpEF patients.In recent years,two diagnostic scoring systems,HFA-PEFF and H2FPEF,have appeared in order to clarify the diagnosis of HFpEF.However,due to the lack of understanding of the mechanism of HFpEF,the lack of specific indicators and the high requirements of related examination techniques,the diagnostic criteria of HFpEF have not been unified.This paper reviews the diagnostic points,related scoring systems and research progress of HFpEF.