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Heart Failure With Preserved Ejection Fraction ― Time for a Paradigm Shift Beyond Diastolic Function ―
At present, heart failure with preserved ejection fraction (HFpEF) is a commonly accepted condition in HF patients. In contrast to HF with reduced EF (HFrEF), HFpEF is strongly associated with aging, and vascular, metabolic, neurohormonal, and systemic inflammatory comorbidities. Two major hypothese...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Japanese Circulation Society
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7925123/ https://www.ncbi.nlm.nih.gov/pubmed/33693069 http://dx.doi.org/10.1253/circrep.CR-18-0017 |
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author | Oki, Takashi Miyoshi, Hirokazu Oishi, Yoshifumi Iuchi, Arata Kusunose, Kenya Yamada, Hirotsugu Klein, Allan L. |
author_facet | Oki, Takashi Miyoshi, Hirokazu Oishi, Yoshifumi Iuchi, Arata Kusunose, Kenya Yamada, Hirotsugu Klein, Allan L. |
author_sort | Oki, Takashi |
collection | PubMed |
description | At present, heart failure with preserved ejection fraction (HFpEF) is a commonly accepted condition in HF patients. In contrast to HF with reduced EF (HFrEF), HFpEF is strongly associated with aging, and vascular, metabolic, neurohormonal, and systemic inflammatory comorbidities. Two major hypotheses explain the pathophysiology of HFpEF (stages C,D in the American College of Cardiology Foundation/American Heart Association HF staging system): (1) impaired active relaxation and increased passive stiffness of the left ventricular (LV) myocardium during diastole (left atrial [LA]-LV coupling); and (2) LV and arterial stiffening during systole (LV-arterial coupling). Cardiac structural and functional abnormalities can be evaluated using non-invasive measures, such as 2-D, flow velocity Doppler, and tissue Doppler echocardiography, to estimate LV filling pressure and afterload mismatch. The clinical application of 2-D speckle-tracking echocardiography (2D-STE) is feasible for earlier diagnosis of functional abnormalities of the LA, LV, and elastic arteries in asymptomatic patients with cardiovascular risk factors (stages A,B). The goal of this review is to highlight the role of 2D-STE to detect impairment of LA-LV-arterial coupling beyond diastolic function earlier, because it may provide important information on the pathophysiology and prevention of HFpEF. |
format | Online Article Text |
id | pubmed-7925123 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | The Japanese Circulation Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-79251232021-03-09 Heart Failure With Preserved Ejection Fraction ― Time for a Paradigm Shift Beyond Diastolic Function ― Oki, Takashi Miyoshi, Hirokazu Oishi, Yoshifumi Iuchi, Arata Kusunose, Kenya Yamada, Hirotsugu Klein, Allan L. Circ Rep Review At present, heart failure with preserved ejection fraction (HFpEF) is a commonly accepted condition in HF patients. In contrast to HF with reduced EF (HFrEF), HFpEF is strongly associated with aging, and vascular, metabolic, neurohormonal, and systemic inflammatory comorbidities. Two major hypotheses explain the pathophysiology of HFpEF (stages C,D in the American College of Cardiology Foundation/American Heart Association HF staging system): (1) impaired active relaxation and increased passive stiffness of the left ventricular (LV) myocardium during diastole (left atrial [LA]-LV coupling); and (2) LV and arterial stiffening during systole (LV-arterial coupling). Cardiac structural and functional abnormalities can be evaluated using non-invasive measures, such as 2-D, flow velocity Doppler, and tissue Doppler echocardiography, to estimate LV filling pressure and afterload mismatch. The clinical application of 2-D speckle-tracking echocardiography (2D-STE) is feasible for earlier diagnosis of functional abnormalities of the LA, LV, and elastic arteries in asymptomatic patients with cardiovascular risk factors (stages A,B). The goal of this review is to highlight the role of 2D-STE to detect impairment of LA-LV-arterial coupling beyond diastolic function earlier, because it may provide important information on the pathophysiology and prevention of HFpEF. The Japanese Circulation Society 2018-12-14 /pmc/articles/PMC7925123/ /pubmed/33693069 http://dx.doi.org/10.1253/circrep.CR-18-0017 Text en Copyright © 2019, THE JAPANESE CIRCULATION SOCIETY This article is licensed under a Creative Commons [Attribution-NonCommercial-NoDerivatives 4.0 International] license.https://creativecommons.org/licenses/by-nc-nd/4.0/ |
spellingShingle | Review Oki, Takashi Miyoshi, Hirokazu Oishi, Yoshifumi Iuchi, Arata Kusunose, Kenya Yamada, Hirotsugu Klein, Allan L. Heart Failure With Preserved Ejection Fraction ― Time for a Paradigm Shift Beyond Diastolic Function ― |
title | Heart Failure With Preserved Ejection Fraction ― Time for a Paradigm Shift Beyond Diastolic Function ― |
title_full | Heart Failure With Preserved Ejection Fraction ― Time for a Paradigm Shift Beyond Diastolic Function ― |
title_fullStr | Heart Failure With Preserved Ejection Fraction ― Time for a Paradigm Shift Beyond Diastolic Function ― |
title_full_unstemmed | Heart Failure With Preserved Ejection Fraction ― Time for a Paradigm Shift Beyond Diastolic Function ― |
title_short | Heart Failure With Preserved Ejection Fraction ― Time for a Paradigm Shift Beyond Diastolic Function ― |
title_sort | heart failure with preserved ejection fraction ― time for a paradigm shift beyond diastolic function ― |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7925123/ https://www.ncbi.nlm.nih.gov/pubmed/33693069 http://dx.doi.org/10.1253/circrep.CR-18-0017 |
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