Abstract:
:Evidence-based management of heart failure (HF) with preserved left ventricular ejection fraction (LVEF; HFpEF) remains a major gap in the care of patients with HF. Clinical trials directed toward the population with HFpEF have been disappointing, although renin-angiotensin-aldosterone system blockade appears to prevent HF in populations predisposed to HFpEF. This paradox may partly be because of inhomogeneity within the HF populations studied. Although the term HFpEF is often used to imply a specific diagnosis, in fact this constellation may be due to a large variety of disease states with different underlying pathophysiologic mechanisms. Furthermore, in patients with HF, regardless of LVEF, myocardial dysfunction is common during both systole and diastole, and LVEF is influenced at least as much by the pattern of left ventricular remodeling as it is by myocardial contractility. The most common clinical-pathologic syndrome responsible for HFpEF is strongly associated with hypertension, with the metabolic syndrome, and with older age. Recent findings support that this condition is mediated via endothelial dysfunction, inflammation, oxidative stress, myocyte hypertrophy, and altered collagen turnover. We, therefore, propose the terms "metabolic HF" and "senile HF" to describe this specific disease state. The search for therapies designed to prevent, halt, or reverse HF should more strongly focus on populations carefully selected to represent specific underlying cardiovascular disease states.
journal_name
Cardiol Revjournal_title
Cardiology in reviewauthors
Jumean MF,Konstam MAdoi
10.1097/CRD.0000000000000057subject
Has Abstractpub_date
2015-07-01 00:00:00pages
161-7issue
4eissn
1061-5377issn
1538-4683journal_volume
23pub_type
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journal_title:Cardiology in review
pub_type: 杂志文章,评审
doi:10.1097/CRD.0b013e31815cb185
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journal_title:Cardiology in review
pub_type: 杂志文章,评审
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journal_title:Cardiology in review
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pub_type: 杂志文章,meta分析,评审
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pub_type: 杂志文章,评审
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更新日期:2009-07-01 00:00:00
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pub_type: 历史文章,杂志文章,评审
doi:10.1097/CRD.0b013e31828a8294
更新日期:2013-09-01 00:00:00
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pub_type: 杂志文章
doi:10.1097/01.crd.0000115927.76990.25
更新日期:2004-05-01 00:00:00
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pub_type: 杂志文章,评审
doi:10.1097/CRD.0000000000000184
更新日期:2018-05-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2019-11-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2016-07-01 00:00:00
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pub_type: 杂志文章
doi:10.1097/CRD.0000000000000327
更新日期:2020-06-18 00:00:00
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journal_title:Cardiology in review
pub_type: 杂志文章,评审
doi:10.1097/00045415-200209000-00003
更新日期:2002-09-01 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章,评审
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pub_type: 杂志文章,评审
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更新日期:2007-07-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2012-09-01 00:00:00
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