保存喷射分数 (HFpEF) 的心力衰竭:转化机制,诊断进化和治疗边界
Lei Gao1, Guofu Zhang1, Kai Kang1
1Department of Cardiovascular Surgery, The First Affiliated Hospital of Harbin Medical University, No. 23, You Zheng Street, Harbin 150000, Heilongjiang Province, China.
Diabetes research and clinical practice
|January 24, 2026
概括
保存喷射分数 (HFpEF) 的心力衰竭涉及到心脏之外的复杂途径,导致腹功能障碍. 像SGLT2抑制剂这样的新疗法提供了疾病修饰,改善了对这种常见疾病的管理.
科学领域:
- 心脏病学和心血管研究.
- 翻译医学和多态医学.
- 心力衰竭的系统生物学.
背景情况:
- 保存喷射分数 (HFpEF) 的心力衰竭占所有心力衰竭病例的一半.
- HFpEF具有显著的症状负担,频繁的住院治疗和有限的治疗选择.
- 病理生理学涉及血管,心肌,新陈代谢和炎症系统的复杂相互作用,导致腹功能障碍和全身重塑.
研究的目的:
- 综合当前关于高风环境环境环境疫学,机制,诊断和管理的证据.
- 突出最近的治疗进展和未来的研究方向.
- 将HFpEF视为由透缩功能障碍统一的内型谱.
主要方法:
- 综合审查当代科学文献.
- 综合有关流行病学数据,机制性见解,诊断方法和治疗策略的证据.
- 对新兴治疗方法的分析,包括SGLT2抑制剂,GLP-1RA和sGC刺激剂.
主要成果:
- HFpEF 病理生理学是多因素的,涉及除心室之外的全身途径.
- 糖共传输体-2 (SGLT2) 抑制剂已被确立为基础疗法.
- 类似葡萄糖-1受体激动剂 (GLP-1RAs) 显示为心脏代谢性HFpEF的辅助疗法具有前途.
结论:
- HFpEF是一种异质的疾病,具有不同的内型.
- 精准医学方法需要整合多omics数据与深度临床表型.
- 未来的研究应该专注于针对个性化的预防和治疗的内型分层临床试验.
相关概念视频
Heart Failure IV: Classification and Diagnostic Evaluation
345
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...
345
Heart Failure II: Pathophysiology
822
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...
822
Pathophysiology of Heart Failure
3.2K
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...
3.2K
Heart Failure I: Introduction
757
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...
757
Heart Failure VI: Adjunct Therapies
292
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
292
Heart Failure Drugs: Diuretics
862
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
862


