舒张性心力衰竭诊断和治疗专家共识

廖玉华; 杨杰孚; 张健; 程翔; 谢明星; 李新立; 董吁钢; 周京敏; 伍伟锋; 郭小梅

doi:10.13201/j.issn.1001-1439.2020.01.001

舒张性心力衰竭诊断和治疗专家共识

- 1. 华中科技大学同济医学院附属协和医院心内科(武汉, 430022);
- 2. 北京医院心内科;
- 3. 中国医学科学院阜外医院心内科;
- 4. 南京医科大学第一附属医院心内科;
- 5. 中山大学附属第一医院心内科;
- 6. 复旦大学附属中山医院心内科;
- 7. 广西医科大学第一附属医院心内科;
- 8. 华中科技大学同济医学院附属同济医院心内科

详细信息

通讯作者: 廖玉华,E-mail:liaoyh27@163.com

中图分类号: R541.6

收稿日期: 2019-11-25

An expert consensus for diagnosis and treatment of diastolic heart failure

- 1. Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China;
- 2. Department of Cardiology, Beijing Hospital;
- 3. Department of Cardiology, Fuwai Hospital of Chinese Academy of Medical Sciences;
- 4. Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University;
- 5. Department of Cardiology, The First Affiliated Hospital of Sun Yat-sen University;
- 6. Department of Cardiology, Zhongshan Hospital Affiliated to Fudan University;
- 7. Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University;
- 8. Department of Cardiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology

More Information

Corresponding author: LIAO Yuhua, E-mail: liaoyh27@163.com

Received Date: 25 November 2019

摘要

摘要: 心力衰竭(心衰)是一种异质性很强的复杂临床综合征,根据左室射血分数对心衰进行分类简便易行,但存在局限性。收缩性心衰(SHF)与舒张性心衰(DHF)病理生理机制不同,SHF应用神经激素拮抗剂治疗显著获益,DHF病理生理机制涉及系统性炎症、代谢紊乱、心外膜脂肪组织堆积、心肌微血管功能障碍、心肌纤维化等,DHF的有效治疗尚未明确。DHF诊断建议采用超声心动图提出的心功能诊断标准。目前DHF治疗策略包括对症治疗、探索性抗炎症和抗代谢药物治疗。为了减少心衰再住院率,神经激素拮抗剂适用于大多数SHF合并DHF患者的治疗。
- 舒张性心力衰竭 /
- 病理生理 /
- 诊断 /
- 治疗
Abstract: Heart failure(HF) is a complex clinical syndrome with high heterogenity,so the traditional classification of this disease,depending on left ventricular ejection fraction,might have some limitations,although it is easy to carry out.Nowadays,growing evidences showed that the underlying pathophysiological mechanism of diastolic heart failure(DHF) was probably differed from systolic heart failure(SHF).Neurohormone antagonists presented uncertain effects on DHF instead of remarkable efficacy in SHF patients.Various factors,including systemic inflammatory responses,metabolic disorders,epicardial adipose tissue accumulation,myocardial fibrosis,were currently indicated to participate in the development of DHF.It is recommended that the evaluation parameters of diastolic function by echocardiography are critical criteria for diagnosis of DHF.The treatment of DHF needs further exploration,especially in anti-inflammatory and antimetabolite agents,except for some symtomatic treatments.The neurohormone antagonists could be used for SHF combined with DHF patients to reduce their HF readmission rates.
- diastolic heart failure /
- pathophysiology /
- diagnosis /
- treatments

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