Noncardiac Comorbidities in Heart Failure With Reduced Versus Preserved Ejection Fraction

被引：490

作者：

Mentz, Robert J. ^{[1
]}

Kelly, Jacob P. ^{[1
]}

von Lueder, Thomas G. ^{[2
,3
]}

Voors, Adriaan A. ^{[4
]}

Lam, Carolyn S. P. ^{[5
,6
]}

Cowie, Martin R. ^{[7
,8
]}

Kjeldsen, Keld ^{[9
,10
]}

Jankowska, Ewa A. ^{[11
]}

Atar, Dan ^{[2
,3
]}

Butler, Javed ^{[12
]}

Fiuzat, Mona ^{[1
]}

Zannad, Faiez ^{[13
,14
]}

Pitt, Bertram ^{[15
]}

O'Connor, Christopher M. ^{[1
]}

机构：

[1] Duke Univ, Durham, NC 27710 USA

[2] Univ Oslo, Oslo Univ Hosp, Oslo, Norway

[3] Univ Oslo, Inst Clin Sci, Oslo, Norway

[4] Univ Groningen, Univ Med Ctr Groningen, Groningen, Netherlands

[5] Framingham Heart Dis Epidemiol Study, Framingham, MA 02118 USA

[6] Boston Univ, Sch Med, Boston, MA 02118 USA

[7] Univ London Imperial Coll Sci Technol & Med, Natl Heart & Lung Inst, London, England

[8] Univ London Imperial Coll Sci Technol & Med, Royal Brompton Hosp, London, England

[9] Univ Copenhagen Hosp, Rigshosp, DK-2100 Copenhagen, Denmark

[10] Aalborg Univ, Aalborg, Denmark

[11] Wroclaw Med Univ, Dept Heart Dis, Wroclaw, Poland

[12] Emory Univ, Atlanta, GA 30322 USA

[13] Univ Lorraine, INSERM, Ctr Invest Clin, Nancy, France

[14] CHU Nancy, Nancy, France

[15] Univ Michigan, Sch Med, Ann Arbor, MI 48109 USA

来源：

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY | 2014年 / 64卷 / 21期

基金：

美国国家卫生研究院;

关键词：

OBSTRUCTIVE PULMONARY-DISEASE; VENTRICULAR SYSTOLIC FUNCTION; CENTRAL SLEEP-APNEA; POSITIVE AIRWAY PRESSURE; RENAL-FUNCTION; CLINICAL CHARACTERISTICS; DIABETES-MELLITUS; CONTROLLED-TRIAL; IRON-DEFICIENCY; HIGH PREVALENCE;

D O I：

10.1016/j.jacc.2014.08.036

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

Heart failure patients are classified by ejection fraction (EF) into distinct groups: heart failure with preserved ejection fraction (HFpEF) or heart failure with reduced ejection fraction (HFrEF). Although patients with heart failure commonly have multiple comorbidities that complicate management and may adversely affect outcomes, their role in the HFpEF and HFrEF groups is not well-characterized. This review summarizes the role of noncardiac comorbidities in patients with HFpEF versus HFrEF, emphasizing prevalence, underlying pathophysiologic mechanisms, and outcomes. Pulmonary disease, diabetes mellitus, anemia, and obesity tend to be more prevalent in HFpEF patients, but renal disease and sleep-disordered breathing burdens are similar. These comorbidities similarly increase morbidity and mortality risk in HFpEF and HFrEF patients. Common pathophysiologic mechanisms include systemic and endomyocardial inflammation with fibrosis. We also discuss implications for clinical care and future HF clinical trial design. The basis for this review was discussions between scientists, clinical trialists, and regulatory representatives at the 10th Global CardioVascular Clinical Trialists Forum. (C) 2014 by the American College of Cardiology Foundation.

引用

页码：2281 / 2293

页数：13

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