[Diagnosis and treatment of heart failure with preserved ejection fraction].

IF 0.9 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Herz Pub Date : 2025-10-01 Epub Date: 2025-08-25 DOI:10.1007/s00059-025-05327-9

Samira Soltani, Johann Bauersachs

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引用次数: 0

Abstract

The treatment of heart failure with preserved ejection fraction (HFpEF) involves symptomatic management of congestion with diuretics (class I recommendation) and treatment with sodium-glucose linked transporter 2 (SGLT2) inhibitors for improvement of the prognosis, which have a class I recommendation across the entire spectrum of left ventricular ejection fraction (LVEF) in the current guidelines. The data supporting the recommendation of SGLT2 inhibitors in HFpEF come from the EMPEROR-Preserved and DELIVER studies. The FINEARTS-HF study showed positive effects on cardiovascular death/heart failure hospitalization of the treatment of HFpEF patients with finerenone, a nonsteroidal mineralocorticoid receptor antagonist. The STEP-HFpEF (2023) and SUMMIT (2024) studies investigated the treatment with glucagon-like peptide 1 (GLP-1) analogs in patients with HFpEF and obesity and showed positive outcomes regarding quality of life and, in the latter study, positive effects on heart failure events. The treatment of severe mitral and tricuspid valve regurgitation impacts not only the symptom burden but also hospitalization and overall prognosis in HFpEF patients.

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[保留射血分数的心力衰竭诊断与治疗]。

保留射血分数（HFpEF）治疗心力衰竭包括利尿剂充血的症状管理（推荐I类）和钠-葡萄糖连接转运蛋白2 （SGLT2）抑制剂的治疗，以改善预后，在目前的指南中，这在整个左心室射血分数（LVEF）范围内被推荐为I类。支持推荐SGLT2抑制剂治疗HFpEF的数据来自EMPEROR-Preserved和DELIVER研究。finhearts - hf研究显示，使用非甾体矿物皮质激素受体拮抗剂finerenone治疗HFpEF患者对心血管死亡/心力衰竭住院有积极影响。STEP-HFpEF（2023）和SUMMIT（2024）研究调查了胰高血糖素样肽1 （GLP-1）类似物对HFpEF和肥胖患者的治疗，结果显示胰高血糖素样肽1 （GLP-1）类似物对生活质量有积极影响，在后者的研究中，对心力衰竭事件有积极影响。重度二尖瓣和三尖瓣反流的治疗不仅影响患者的症状负担，而且影响患者的住院和整体预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Herz 医学-心血管系统

CiteScore

3.00

自引率

5.90%

发文量

审稿时长

4-8 weeks

期刊介绍： Herz is the high-level journal for further education for all physicians interested in cardiology. The individual issues of the journal each deal with specific topics and comprise review articles in English and German written by competent and esteemed authors. They provide up-to-date and comprehensive information concerning the speciality dealt with in the issue. Due to the fact that all relevant aspects of the pertinent topic of an issue are considered, an overview of the current status and progress in cardiology is presented. Reviews and original articles round off the spectrum of information provided.