在左心室射出小部分范围内保持心力衰竭的特征
Sebastian Rosch1, Karl-Patrik Kresoja1, Christian Besler1
1Departments of Cardiology (S.R., K.-P.K., C.B., K.F., A.R.S., M.v.R., H.T., K.-P.R., P.L.), Heart Center Leipzig at University of Leipzig, Germany.
Circulation
|July 21, 2022
概括
通过左心室喷射分数 (LVEF) 对心力衰竭保持喷射分数 (HFpEF) 的分层,可以发现不同的患者子组. 这些HFpEF亚群具有独特的病理生理特征,指导个性化治疗策略.
科学领域:
- 心脏病学
- 心脏衰竭的研究
- 医学成像
背景情况:
- 治疗心力衰竭与保存的喷射分数 (HFpEF) 的反应有所不同.
- 通过左心室喷射分数 (LVEF) 对HFpEF患者进行分层可能会使治疗结果有所不同.
- 在HFpEF亚组中差异化的病理生理机制尚不清楚.
研究的目的:
- 通过LVEF对HFpEF患者的独特病理生理特征进行研究.
- 为了比较HFpEF患者之间的心脏形态和功能,LVEF为50% - 60%和LVEF> 60%.
主要方法:
- 对有症状的HFpEF患者进行前性单中心研究.
- 心脏磁共振成像 (CMR) 和压力体积循环分析.
- 患者分为50-60%的LVEF和60%以上的LVEF.
主要成果:
- 大于60%的LVEF群体具有较低的LV体积,但具有较高的收缩性和扩张性硬度.
- 在50% - 60%的LVEF队列中观察到心室 - 动脉合障碍.
- 超过60%的LVEF群体在运动期间表现出超收缩状态,预负荷储备减少.
结论:
- 50% - 60% 的HFpEF患者的收缩能力降低,并出现合障碍.
- 患者的HFpEF LVEF> 60% 呈现高收缩性和负荷动态变化.
- 基于LVEF的分层识别出不同的HFpEF病理学亚现象.
相关概念视频
Pathophysiology of Heart Failure
1.8K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
1.8K
Heart Failure IV: Classification and Diagnostic Evaluation
27
Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
27
Heart Failure III: Clinical Manifestations
39
Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...
39
Heart Failure II: Pathophysiology
31
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
31
Heart Failure I: Introduction
46
Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
46
Imbalances in Cardiac Output
1.5K
The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
1.5K


