Heart Failure With Preserved Ejection Fraction and Atrial Fibrillation Vicious Twins

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

卷:68

Review

Kotecha, Dipak¹  Lam, Carolyn S. P.²  Van Veldhuisen, Dirk J.³  Van Gelder, Isabelle C.³  Voors, Adriaan A.³  Rienstra, Michiel³ 

[1] Univ Birmingham, Inst Cardiovasc Sci, Birmingham, W Midlands, England

[2] Natl Heart Ctr Singapore, Dept Cardiol, Singapore, Singapore

[3] Univ Groningen, Univ Med Ctr Groningen, Groningen, Netherlands

关键词: age;    diagnosis;    epidemiology;    natriuretic peptides;    outcomes;   

DOI  :  10.1016/j.jacc.2016.08.048

来源: Elsevier

【 摘 要 】

Heart failure with preserved ejection fraction (HFpEF) and atrial fibrillation (AF) are age-related conditions that are increasing in prevalence, commonly coexist, and share clinical features. This review provides a practical update on the epidemiology, pathophysiology, diagnosis, and management of patients with concomitant HFpEF and AF. Epidemiological studies highlight the close and complex links between HFpEF and AF, the shared risk factors, the high AF occurrence in the natural history of HFpEF, and the independent contribution of each condition to poor outcomes. Diagnosis of HFpEF in the setting of AF is challenging because the symptoms overlap. AF is associated with changes in echocardiographic parameters and circulating natriuretic peptides that confound HFpEF diagnosis. Symptomatic improvement with diuretic therapy supports the presence of HFpEF in patients with concomitant AF. Important knowledge gaps need to be addressed by a multidisciplinary and translational research approach to develop novel therapies that can improve prognosis. (C) 2016 by the American College of Cardiology Foundation.

【 授权许可】

Free