共查询到20条相似文献，搜索用时 31 毫秒
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Michael A. Chen 《The American journal of medicine》2009,122(8):713-723
Age-associated physiologic changes predispose older adults to develop heart failure, even when left ventricular ejection fraction is normal or near normal. Heart failure with a preserved ejection fraction is particularly common in older hypertensive women, and hypertension plays a key role in its pathophysiology. In contrast with heart failure with a reduced ejection fraction, the treatment of heart failure with a preserved ejection fraction has a limited empiric basis, although some basic principles are useful. Ongoing studies provide hope of improving care of these patients. 相似文献
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心力衰竭是一种心脏结构或功能异常所致的临床综合征,据推测目前中国心血管病患者人数为2.9亿,其中心力衰竭占据450万。依据左心室射血分数,心力衰竭又分为射血分数降低性心力衰竭(HFrEF)和射血分数保留性心力衰竭(HFpEF)。近年来,HFpEF的发病率明显较HFrEF增加且已成为研究的热点。高血压、糖尿病和冠心病是常见能导致心力衰竭的基础疾病,其中糖尿病是最常见合并症之一。在美国,糖尿病在HFpEF中的患病率约为45%,但人们对这一人群的特征和结果了解甚少,在中国更是这样。现总结几项HFpEF治疗临床试验的数据,这些数据都表明糖尿病与HFpEF的发病率和长期死亡率增加有关,并讨论了HFpEF和糖尿病中的几种常见病理机制,包括钠潴留、代谢紊乱、骨骼肌功能受损和潜在的治疗靶点。随着对合并HFpEF和糖尿病的理解的增加,希望能为临床医生更好地提供有效的治疗方法。 相似文献
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射血分数中间范围心力衰竭(HFmrEF)作为一种特殊类型的心力衰竭表型,处于射血分数降低性心力衰竭(HFrEF)与射血分数保留性心力衰竭(HFpEF)之间的"灰色区域",目前研究对于HFmrEF是为一个独立的临床综合征还是介于HFrEF和HFpEF之间的"过渡阶段"存在一定争议.现对HFmrEF的流行病学、机制、治疗和... 相似文献
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Kay-Won Chang Neil Beri Nghia H. Nguyen Boris Arbit Sutton Fox Sean Mojaver Paul Clopton S. William Tam Anne L. Taylor Jay N. Cohn Alan S. Maisel Inder S. Anand 《Journal of cardiac failure》2018,24(5):303-309
Background
Recent studies have described the entity of heart failure with recovered ejection fraction (HFrecEF), but population-specific studies remain lacking. The aim of this study was to characterize patients enrolled in the African-American Heart Failure Trial (A-HeFT) who had significant improvement in their ejection fraction (EF) during the 1st 6 months of follow-up.Methods and Results
Subjects with HFrecEF (improvement in EF from <35% to >40% in 6 months; n?=?59) were compared with 259 subjects with heart failure and persistently reduced EF (HFrEF), defined as EF ≤40% at 6-month follow-up. The effects of improvement in EF on all-cause mortality and 1st and all hospitalizations were analyzed. Compared with HFrEF, subjects with HFrecEF had a nonsignificant trend toward lower mortality (hazard ratio [HR] 0.16, 95% confidence interval [CI] 0.02–1.15; P?=?.068), fewer 1st HF hospitalizations (HR 0.22, 95% CI 0.07–0.71; P?=?.011), fewer recurrent HF hospitalizations (HR 0.13, 95% CI 0.05–0.37; P?<.001), similar 1st all-cause hospitalizations (HR 0.67, 95% CI 0.39–1.15; P?=?.150), and fewer recurrent all-cause hospitalizations (HR 0.41, 95% CI 0.24–0.68; P?<.001).Conclusions
These data confirm that, as in other populations, a small subgroup of black patients receiving standard care improve their EF with favorable outcomes. Further studies are required to determine whether myocardial recovery is permanent and the best management strategies in such patients. 相似文献18.
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