Abstract:
:It is now clear that diastolic heart failure (DHF) is an important, perhaps even dominant form of heart failure in older Americans. However, our knowledge base regarding the epidemiology, pathophysiology, natural history, and therapy of this relatively recently recognized disorder is limited. A number of normal age related changes in the heart and vascular system may predispose to or lower the threshold for expression of DHF. Recent reports from large population-based observational studies indicate that over 50% of persons 65 years and older who have heart failure have normal LV systolic function (presumed DHF). Among these, 45% have no other confounding variables (coronary, valvular, or pulmonary disease) and meet the criteria for isolated DHF. DHF is substantially more common in older women than men. A history of systemic hypertension and left ventricular hypertrophy are almost invariably present. Mortality rates are about 50% lower in DHF than in systolic heart failure (SHF) when stable outpatients are considered. However, in hospitalized and very elderly patients, the mortality rate appears similar in DHF and SHF. Furthermore, due to its higher prevalence, the total mortality in the older population attributable to DHF exceeds that of SHF. Morbidity in DHF is substantial and approaches that of SHF. In the chronic setting, DHF patients can have severe exercise intolerance related to failure of the Frank-Starling mechanism with reduced peak cardiac output, heart rate, and stroke volume and increased LV filling pressure. DHF patients also appear to have increased vascular stiffness, accelerated systolic blood pressure response to exercise, neuroendocrine activation, and reduced quality of life. Acute exacerbations (pulmonary edema) frequently occur and are associated with severe hypertension, sodium indiscretion, and medication non-compliance. Surprisingly, overt myocardial ischemia appears to infrequently play a role in these acute exacerbations. Therapy is currently empiric and multicenter, randomized, controlled trials are urgently needed. Anecdotally, control of blood pressure appears to improve symptoms and reduce the frequency of acute exacerbations. In addition, non-pharmacologic intervention, including multi-disciplinary case management is useful.
journal_name
Heart Fail Revjournal_title
Heart failure reviewsauthors
Kitzman DWdoi
10.1023/a:1013745705318subject
Has Abstractpub_date
2002-01-01 00:00:00pages
17-27issue
1eissn
1382-4147issn
1573-7322journal_volume
7pub_type
杂志文章,评审abstract::The prevalence of heart failure (HF) is increasing. A distinction is made between diastolic HF (preserved left ventricular ejection fraction (LVEF)) and systolic HF (reduced LVEF). Advanced glycation end-products (AGEs) are crystallized proteins that accumulate during ageing, but are particularly increased in patients...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-010-9225-z
更新日期:2012-03-01 00:00:00
abstract::Heart failure continues to be associated with high morbidity and mortality. Over the past decade, left ventricular assist devices have been shown to improve the survival and quality of life. However, it is quite clear that very sick patients do not do as well, and it is therefore imperative to select patients at the p...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-012-9316-0
更新日期:2013-01-01 00:00:00
abstract::Acute heat failure syndromes are a heterogenous group of conditions. Chronic heart failure exacerbations represent the vast majority of cases. Pathophysiologic mechanisms, such as hypotension with peripheral tissue hypoperfusion, renal function impairment and myocardial ischemia and injury, adversely affect patients' ...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-007-9014-5
更新日期:2007-06-01 00:00:00
abstract::Multiple in vitro and in vivo studies showed that the signal transducer and activator of transcription 3 (STAT3) protein is involved in cardiomyocyte protection and hypertrophy and via paracrine pathways impacts on the non-myocyte compartment, i.e., the vasculature and the extracellular matrix. In this regard, STAT3 i...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-010-9170-x
更新日期:2011-01-01 00:00:00
abstract::An important feature of heart failure is the progressive deterioration of left ventricular function that occurs in the absence of clinically apparent intercurrent adverse events. The mechanism or mechanisms responsible for this hemodynamic deterioration are not known. We and others have advanced the hypothesis that th...
journal_title:Heart failure reviews
pub_type: 杂志文章
doi:10.1023/A:1009880720032
更新日期:2000-06-01 00:00:00
abstract::Rheumatic heart disease (RHD) is a major cause of cardiovascular morbidity and mortality in low- and middle-income countries, where living conditions promote spread of group A β-haemolytic streptococcus. Autoimmune reactions due to molecular mimicry of bacterial epitopes by host proteins cause acute rheumatic fever (A...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-020-09993-1
更新日期:2020-07-11 00:00:00
abstract::Heart failure is a complex clinical syndrome associated with a significant morbidity and mortality burden. Reductions in left ventricular (LV) function trigger adaptive mechanisms, leading to structural changes within the LV and the potential development of dyssynchronous ventricular activation. This is the substrate ...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-018-9734-8
更新日期:2019-01-01 00:00:00
abstract::The spectrum of ischemic heart diseases, encompassing acute myocardial infarction to heart failure, represents the leading cause of death worldwide. Although extensive progress in cardiovascular diagnoses and therapy has been made, the prevalence of the disease continues to increase. Cardiac regeneration has a promisi...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-020-09953-9
更新日期:2020-04-18 00:00:00
abstract::From previous systematic reviews and meta-analyses, there is consensus about the positive effect of exercise training on exercise capacity for systolic heart failure (HF); however, the effect on actual prognostic markers such as NTproBNP and minute ventilation/carbon dioxide production (VE/VCO2) slope has not been eva...
journal_title:Heart failure reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s10741-013-9407-6
更新日期:2014-09-01 00:00:00
abstract::There is substantial causal and consequential interaction between the ever-growing heart failure and renal failure patients. Half of the patients with heart failure (HF) have preserved left ventricular ejection fraction (HFpEF), which is difficult to diagnose and rising in prevalence relative to HF with reduced EF (HF...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-017-9619-2
更新日期:2017-11-01 00:00:00
abstract::Diabetes and heart failure (HF) are both global epidemics with tremendous costs on society with increased rates of HF hospitalizations and worsened prognosis when co-existing, making it a significant "deadly duo." The evidence for pharmacological treatment of HF in patients with type 2 diabetes mellitus (T2DM) stems t...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-018-9685-0
更新日期:2018-05-01 00:00:00
abstract::Autophagy plays a critical and seemingly dual-purposed role in cardiomyocytes, being implicated as a mechanism of both cellular survival, for example, during ischemia/reperfusion injury and a mechanism of cell death at stages in which progressive myocyte alterations are beyond repair. This review aims to highlight the...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-009-9137-y
更新日期:2010-01-01 00:00:00
abstract::The diagnosis and management of heart failure remains challenging despite considerable clinical advances in recent decades. With greater understanding of the pathophysiology of this complex syndrome, a large number of candidate biomarkers have emerged and duly received scientific and clinical attention. These are freq...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-008-9123-9
更新日期:2010-07-01 00:00:00
abstract::Despite therapeutic advances, patients with worsening heart failure (HF) requiring hospitalization have unacceptably high post-discharge mortality and re-admission rates soon after discharge. Evidence suggests a hypercoagulable state is present in patients with HF. Although thromboembolism as a direct consequence of H...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-012-9343-x
更新日期:2013-11-01 00:00:00
abstract::Brief ischemia to the myocardium initiates a cascade of biochemical events in cardiac myocytes that protects the heart muscle during subsequent ischemic insults. This phenomenon is called ischemic preconditioning. If an acute myocardial infarction is preceded by preinfarction angina, it results in smaller infarction s...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-007-9037-y
更新日期:2007-12-01 00:00:00
abstract::The underlying mechanism for clinical and biochemical manifestations of chronic heart failure (HF) may be due in part to neurohumoral adaptations, such as activation of the renin-angiotensin-aldosterone and sympathetic nervous systems in the periphery and the brain. Internet search and discussion with colleagues are t...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-018-9747-3
更新日期:2019-03-01 00:00:00
abstract::Significant growth in the elderly population (age ≥ 65 years) with heart failure (HF) has taken place in developed countries and is occurring in most developing countries. Projections from population studies in the United States, Europe and other developed countries suggest that this trend will very likely continue an...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-012-9299-x
更新日期:2012-09-01 00:00:00
abstract::Chronic obstructive pulmonary disease (COPD) is a major health problem worldwide, with co-morbidities contributing to the overall severity and mortality of the disease. The incidence and prevalence of cardiovascular disease among COPD patients are high. Both disorders often co-exist, mainly due to smoking, but they al...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-017-9646-z
更新日期:2017-11-01 00:00:00
abstract::Cardiac fibrosis is associated with non-ischemic dilated cardiomyopathy, increasing its morbidity and mortality. Cardiac fibroblast is the keystone of fibrogenesis, being activated by numerous cellular and humoral factors. Macrophages, CD4+ and CD8+ T cells, mast cells, and endothelial cells stimulate fibrogenesis dir...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-020-09940-0
更新日期:2020-03-13 00:00:00
abstract::Acute heart failure hospitalizations complicated by diuretic resistance are associated with worse outcomes. Yet, quantification of the frequency and accompanying risk from loop diuretic resistance is limited by the absence of a comprehensive definition with universal clinical application. Herein, we outline limitation...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-019-09851-9
更新日期:2020-01-01 00:00:00
abstract::There was a mistake in Prof. Giuseppe Massimo Claudio Rosano's affiliation. ...
journal_title:Heart failure reviews
pub_type: 已发布勘误
doi:10.1007/s10741-020-10000-w
更新日期:2020-09-01 00:00:00
abstract::B-Type natriuretic peptide (BNP) is elevated in states of increased ventricular wall stress. BNP is most commonly used to rule out congestive heart failure (CHF) in dyspneic patients. BNP levels are influenced by age, gender and, to a surprisingly large extent, by body mass index (BMI). In addition, it can be elevated...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-007-9002-9
更新日期:2007-03-01 00:00:00
abstract::Cardiac magnetic resonance spectroscopy (MRS) is a noninvasive method to assess by-products of myocardial metabolism. Recent developments in shorter scan protocols and more powerful field strengths have created interest in utilizing this technology in studying and characterizing the metabolic derangements in heart fai...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-017-9611-x
更新日期:2017-07-01 00:00:00
abstract::The development of a diabetic cardiomyopathy is a multifactorial process, and evidence is accumulating that defects in intracellular free calcium concentration [Ca2+]i or its homeostasis are related to impaired mechanical performance of the diabetic heart leading to a reduction in contractile dysfunction. Defects in r...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-017-9663-y
更新日期:2018-01-01 00:00:00
abstract::Although mineralocorticoid antagonists (MRAs) have been proposed as effective fourth-line blood pressure (BP) lowering agents in resistant hypertension, this effect in heart failure is undetermined. In this synthesis of heart failure randomized controlled trials (RCTs), we evaluated the extent of BP lowering following...
journal_title:Heart failure reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s10741-018-9689-9
更新日期:2018-07-01 00:00:00
abstract::Predictive computational modelling in biomedical research offers the potential to integrate diverse data, uncover biological mechanisms that are not easily accessible through experimental methods and expose gaps in knowledge requiring further research. Recent developments in computing and diagnostic technologies have ...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-016-9528-9
更新日期:2016-11-01 00:00:00
abstract::Heart failure (HF) is associated with a high morbidity and mortality in the Western World. Our knowledge of the epidemiology, pathophysiology, and therapy has improved dramatically during the last 20 years. Pharmacological treatment, as it stands today, is a combination of preventive and symptomatic strategies. The ma...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-006-9482-z
更新日期:2006-06-01 00:00:00
abstract::Right ventricular (RV) diastolic dysfunction was first reported as an indicator for the assessment of ventricular dysfunction in heart failure a little over two decades ago. However, the underlying mechanisms and precise role of RV diastolic dysfunction in heart failure remain poorly described. Complexities in the str...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-015-9472-0
更新日期:2015-05-01 00:00:00
abstract::The evolving paradigm of heart failure has now been expanded to include the favorable neurohormonal, structural and hemodynamic profile of B-type natriuretic peptide [BNP]. As a marker of left ventricular dysfunction, BNP is a practical tool that facilitates diagnosis, contributes to prognostic evaluations and tracks ...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1023/a:1026107701983
更新日期:2003-10-01 00:00:00
abstract::Depression is associated with an increased risk of death in patients with heart failure (HF); however, the association between the use of antidepressants and HF prognoses remains controversial. Therefore, this meta-analysis aimed to evaluate the effect of antidepressants on the risk of death in HF patients. We retriev...
journal_title:Heart failure reviews
pub_type: 杂志文章,评审
doi:10.1007/s10741-019-09850-w
更新日期:2020-11-01 00:00:00