Clinical Update in Heart Failure with Preserved Ejection Fraction.

IF 3.8 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Current Heart Failure Reports Pub Date : 2024-10-01 Epub Date: 2024-09-03 DOI:10.1007/s11897-024-00679-5
Chayakrit Krittanawong, William Michael Britt, Affan Rizwan, Rehma Siddiqui, Muzamil Khawaja, Rabisa Khan, Pouya Joolharzadeh, Noah Newman, Mario Rodriguez Rivera, W H Wilson Tang
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Abstract

Purpose of review: To review the most recent clinical trials and data regarding epidemiology, pathophysiology, diagnosis, and treatment of heart failure with preserved ejection fraction with an emphasis on the recent trends in cardiometabolic interventions.

Recent findings: Heart failure with preserved ejection fraction makes up approximately half of overall heart failure and is associated with significant morbidity, mortality, and overall burden on the healthcare system. It is a complex, heterogenous syndrome and clinical trials, to this point, have not revealed quite as many effective treatment options when compared to heart failure with reduced ejection fraction. Nevertheless, there is an expanding amount of data insight into the pathogenesis of this disease and the potential for newer therapies and management strategies. Heart failure with preserved ejection fraction pathology has been found to be linked to abnormal energetics, myocyte hypertrophy, cell signaling, inflammation, ischemia, and fibrosis. These mechanisms also intricately overlap with the significant comorbidities often associated with heart failure with preserved ejection fraction including, but not limited to, atrial fibrillation, chronic kidney disease, hypertension, obesity and coronary artery disease. Treatment of this disease, therefore, should focus on the management and strict regulation of these comorbidities by pharmacologic and nonpharmacologic means. In this review, a clinical update is provided reviewing the most recent clinical trials and data regarding epidemiology, pathophysiology, diagnosis, and treatment of heart failure with preserved ejection fraction with an emphasis on the recent trend in cardiometabolic interventions.

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射血分数保留型心力衰竭的临床最新进展。
综述目的:回顾有关射血分数保留型心力衰竭的流行病学、病理生理学、诊断和治疗的最新临床试验和数据,重点关注心脏代谢干预的最新趋势:射血分数保留型心力衰竭约占整个心力衰竭的一半,与严重的发病率、死亡率和医疗系统的总体负担有关。这是一种复杂的异质性综合征,与射血分数减低的心力衰竭相比,目前的临床试验还没有发现多少有效的治疗方案。然而,越来越多的数据显示,人们对这种疾病的发病机制以及更新的疗法和管理策略的潜力有了深入的了解。研究发现,射血分数保留型心衰的病理机制与能量异常、心肌细胞肥大、细胞信号传导、炎症、缺血和纤维化有关。这些机制还与通常与射血分数保留型心力衰竭相关的重要合并症错综复杂地重叠在一起,这些合并症包括但不限于心房颤动、慢性肾病、高血压、肥胖和冠状动脉疾病。因此,这种疾病的治疗应侧重于通过药物和非药物手段管理和严格调节这些合并症。在这篇综述中,我们将对射血分数保留型心力衰竭的流行病学、病理生理学、诊断和治疗方面的最新临床试验和数据进行临床更新,并重点介绍心脏代谢干预的最新趋势。
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来源期刊
Current Heart Failure Reports
Current Heart Failure Reports Medicine-Emergency Medicine
CiteScore
5.30
自引率
0.00%
发文量
44
期刊介绍: This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of heart failure. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as investigative, pharmacologic, and nonpharmacologic therapies, pathophysiology, and prevention. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.
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