血液透析患者合并射血分数保留性心衰研究进展

Research Progress in Hemodialysis Patients with Heart Failure with Preserved Ejection Fraction

心血管疾病是血液透析(HD)患者死亡的主要原因。舒张性心力衰竭(DHF),也称为射血分数保留的心衰(HFpEF),是指患者有心衰的症状和体征、正常或接近正常的左心室(LV)收缩功能(射血分数超过50%)和舒张功能障碍(DD)的临床综合征。病理生理学特征是左心房内压升高(LAP),劳累性呼吸困难是其临床表现。研究表明,HFpEF在血液透析患者中非常普遍,而射血分数降低性心衰(HFrEF)只影响少数患者。本文主要对HFpEF的病理生理机制、临床表现、诊断及治疗进行综述。

Cardiovascular disease is the main cause of death in hemodialysis (HD) patients. Diastolic heart failure (DHF), also known as heart failure with preserved ejection fraction (HFpEF), is a clinical syn-drome in which patients have symptoms and signs of heart failure, normal or near-normal left ven-tricular (LV) systolic function (ejection fraction over 50%), and diastolic dysfunction (DD). The pathophysiology is characterized by elevated left atrial pressure (LAP);fatigue dyspnea is its clini-cal manifestation. Studies have shown that HFpEF is common in hemodialysis patients, while heart failure with reduced ejection fraction (HFrEF) affects only a minority. This article reviews the path-ophysiological mechanism, clinical manifestations, diagnosis and treatment of HFpEF.