射血分数中间值的心力衰竭临床研究进展

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摘要心力衰竭是心脏疾病发展的终末阶段，其发病率高、预后差。2016年欧洲心脏病学会将左室射血分数（LVEF）在40％～49％之间的心力衰竭称为射血分数中间值的心力衰竭（HFmrEF）。本文对HFmrEF的临床研究进行总结，发现缺血性心脏病为HFmrEF重要的病因，且合并心房颤动及高血压等多种疾病，临床强调根据病因及合并症制订个性化治疗策略，可能使HFmrEF患者获益更多。在治疗方面，传统药物肾素-血管紧张素-醛固酮系统拮抗剂、β受体阻滞剂及醛固酮受体拮抗剂对HFmrEF仍有积极作用；新兴药物沙库巴曲缬沙坦已成为治疗HFmrEF的药物推荐；部分HFmrEF患者可从维利西呱及羧基麦芽糖铁中获益；钠-葡萄糖协同转运蛋白2抑制剂及Omecamtiv mecarbil对HFmrEF的治疗存在潜力，未来可作为重要研究方向。此外，LVEF的变化对HFmrEF的预后有提示性作用。

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	赛耀庆鲁胜宇曹邦明

关键词 ：射血分数, 心力衰竭, 临床特征, 治疗

Abstract：Heart failure (HF) is the terminal stage of heart disease, with high incidence and poor prognosis. In 2016, European Society of Cardiology defined HF with the left ventricular ejection fraction (LVEF) of 40%-49% as the heart failure with mid-range ejection fraction (HFmrEF). This article summarizes the clinical research on HFmrEF finding that ischemic heart disease is one of the most important factors of HFmrEF, combines with atrial fibrillation and hypertension and other diseases, it emphasizes that personalized treatment strategies based on etiology and complications could bring more benefits to patients suffering from HFmrEF. In terms of treatment, traditional drugs, including renin-angiotensin-aldosterone system antagonists, β-receptor blockers, and aldosterone receptor antagonists still have positive effects on HFmrEF; the emerging drug angiotensinreceptor neprilysin enzyme inhibitor has become a recommendation treatment for HFmrEF; some patients with HFmrEF can benefit from Vericiguat and ferric carboxymaltose; sodium-glucose cotransporter 2 inhibitors, and Omecamtiv mecarbil have potential for the treatment of HFmrEF, and they can be used as important research directions in the future. In addition, the changes of LVEF have suggestive effects on the prognosis of HFmrEF.

Key words： Ejection fraction Heart failure Clinical features Treatment

基金资助:山东省中医药发展计划项目（2019-0509）；
滨州医学院科研计划与科研启动基金项目（BY2018KYQD14）；
滨州医学院“临床医学+X”学位点培育建设项目。

通讯作者: 曹邦明（1970.11-），男，医学博士，教授，硕士生导师，主任医师，主要从事心力衰竭、高血压、急性心肌梗死临床与基础研究。

引用本文:

赛耀庆鲁胜宇曹邦明. 射血分数中间值的心力衰竭临床研究进展[J]. 中国医药导报, 2022, 19(6): 34-38.
SAI Yaoqing LU Shengyu CAO Bangming. Clinical research progress of heart failure with mid-range ejection fraction#br#. 中国医药导报, 2022, 19(6): 34-38.

链接本文:

https://www.yiyaodaobao.com.cn/CN/ 或 https://www.yiyaodaobao.com.cn/CN/Y2022/V19/I6/34

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