Heart failure with preserved ejection fraction: Refocusing on diastole

被引:76
作者
Abbate, Antonio [1 ,2 ]
Arena, Ross [5 ]
Abouzaki, Nayef [1 ]
Van Tassell, Benjamin W. [1 ,2 ,3 ]
Canada, Justin [4 ]
Shah, Keyur [1 ]
Biondi-Zoccai, Giuseppe [6 ]
Voelkel, Norbert F. [2 ]
机构
[1] Virginia Commonwealth Univ, VCU Pauley Heart Ctr, Richmond, VA 23298 USA
[2] Virginia Commonwealth Univ, Victoria Johnson Res Labs, Richmond, VA 23298 USA
[3] Virginia Commonwealth Univ, Dept Pharmacotherapy & Outcome Sci, Richmond, VA 23298 USA
[4] Virginia Commonwealth Univ, Dept Phys Therapy, Richmond, VA 23298 USA
[5] Univ Illinois, Dept Phys Therapy, Chicago, IL USA
[6] Univ Roma La Sapienza, Dept Medicosurg Sci & Biotechnol, Latina, Italy
关键词
Heart failure; Diastole; Physiology; Cardiopulmonary; Exercise; LEFT-VENTRICULAR HYPERTROPHY; RANDOMIZED CONTROLLED-TRIAL; AORTIC-VALVE DISEASE; EXERCISE CAPACITY; RHEUMATOID-ARTHRITIS; SYSTOLIC FUNCTION; CARDIAC STRUCTURE; PROGNOSTIC-SIGNIFICANCE; PULMONARY-HYPERTENSION; EUROPEAN-SOCIETY;
D O I
10.1016/j.ijcard.2014.11.106
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Heart failure (HF) with preserved ejection fraction (HFpEF) is a clinical syndrome of exercise intolerance and/or congestion, in the presence of a left ventricular (LV) ejection fraction within the normal limits (i.e. LVEF > 50%). Determining the presence of impaired LV relaxation and/or filling (diastolic dysfunction) in HFpEF is needed to pragmatically to distinguish it from other cardiac and non-cardiac conditions where symptoms are not due to HF. There are multiple mechanisms for diastolic dysfunction ranging from structural abnormalities to functional derangements in HFpEF yet tailored therapies are lacking. Treatments proven effective in HF with systolic dysfunction have failed to show significant benefit in patients with HFpEF, which prognosis remains poor. This review will discuss the challenges inherent to the use of diagnostic criteria for HFpEF, differential diagnosis, prognostic evaluation, and treatment, highlighting the need for more research in this field. (C) 2014 Published by Elsevier Ireland Ltd.
引用
收藏
页码:430 / 440
页数:11
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