Skip to main content
Erschienen in: Journal of Cardiovascular Translational Research 2/2023

28.09.2022 | Review

Heart Failure with Preserved Ejection Fraction: Pathogenesis, Diagnosis, Exercise, and Medical Therapies

verfasst von: Qingyi Zhan, Wenjing Peng, Siqi Wang, Juan Gao

Erschienen in: Journal of Cardiovascular Translational Research | Ausgabe 2/2023

Einloggen, um Zugang zu erhalten

Abstract

Heart failure with preserved ejection fraction (HFpEF) accounts for more than one-half of total heart failure cases, with a high prevalence and poor prognosis, especially in older and female patients. Patients with HFpEF are characterized by hypertension, left ventricular hypertrophy, and diastolic dysfunction, and the main symptoms are dyspnea and exercise intolerance. HFpEF is currently poorly studied, and pharmacological treatment for HFpEF is still underexplored. Accumulating clinical trials have shown that exercise could exert benefits on diastolic dysfunction and quality of life in patients with HFpEF. However, there is a high limitation for applying exercise therapy due to exercise intolerance in patients with HFpEF. Key effectors of exercise-protection could be novel therapeutic targets for developing drugs to prevent and treat HFpEF. In this review article, we provide an overview of the pathogenic factors, diagnostic methods, research animal models, the mechanisms of exercise-mediated cardiac protection, and current treatments for HFpEF.

Graphical abstract

Literatur
4.
Zurück zum Zitat McDonagh TA, Metra M, Adamo M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021;42(36):3599–726.PubMedCrossRef McDonagh TA, Metra M, Adamo M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021;42(36):3599–726.PubMedCrossRef
5.
Zurück zum Zitat Nunes RB, Alves JP, Kessler LP, Dal Lago P. Aerobic exercise improves the inflammatory profile correlated with cardiac remodeling and function in chronic heart failure rats. Clinics (Sao Paulo). 2013;68(6):876–82.PubMedCrossRef Nunes RB, Alves JP, Kessler LP, Dal Lago P. Aerobic exercise improves the inflammatory profile correlated with cardiac remodeling and function in chronic heart failure rats. Clinics (Sao Paulo). 2013;68(6):876–82.PubMedCrossRef
6.
Zurück zum Zitat Pandey A, Darden D, Berry JD. Low fitness in midlife: a novel therapeutic target for heart failure with preserved ejection fraction prevention. Prog Cardiovasc Dis. 2015;58(1):87–93.PubMedCrossRef Pandey A, Darden D, Berry JD. Low fitness in midlife: a novel therapeutic target for heart failure with preserved ejection fraction prevention. Prog Cardiovasc Dis. 2015;58(1):87–93.PubMedCrossRef
7.
Zurück zum Zitat Leggio M, Fusco A, Loreti C, et al. Effects of exercise training in heart failure with preserved ejection fraction: an updated systematic literature review. Heart Fail Rev. 2020;25(5):703–11.PubMedCrossRef Leggio M, Fusco A, Loreti C, et al. Effects of exercise training in heart failure with preserved ejection fraction: an updated systematic literature review. Heart Fail Rev. 2020;25(5):703–11.PubMedCrossRef
8.
Zurück zum Zitat Bernardo BC, Ooi JYY, Weeks KL, Patterson NL, McMullen JR. Understanding key mechanisms of exercise-induced cardiac protection to mitigate disease: current knowledge and emerging concepts. Physiol Rev. 2018;98(1):419–75.PubMedCrossRef Bernardo BC, Ooi JYY, Weeks KL, Patterson NL, McMullen JR. Understanding key mechanisms of exercise-induced cardiac protection to mitigate disease: current knowledge and emerging concepts. Physiol Rev. 2018;98(1):419–75.PubMedCrossRef
9.
Zurück zum Zitat Jiang HK, Miao Y, Wang YH, et al. Aerobic interval training protects against myocardial infarction-induced oxidative injury by enhancing antioxidase system and mitochondrial biosynthesis. Clin Exp Pharmacol Physiol. 2014;41(3):192–201.PubMedCrossRef Jiang HK, Miao Y, Wang YH, et al. Aerobic interval training protects against myocardial infarction-induced oxidative injury by enhancing antioxidase system and mitochondrial biosynthesis. Clin Exp Pharmacol Physiol. 2014;41(3):192–201.PubMedCrossRef
10.
Zurück zum Zitat Stølen T, Shi M, Wohlwend M, et al. Effect of exercise training on cardiac metabolism in rats with heart failure. Scand Cardiovasc J. 2020;54(2):84–91.PubMedCrossRef Stølen T, Shi M, Wohlwend M, et al. Effect of exercise training on cardiac metabolism in rats with heart failure. Scand Cardiovasc J. 2020;54(2):84–91.PubMedCrossRef
11.
13.
Zurück zum Zitat Kitzman DW, Brubaker P, Morgan T, et al. Effect of caloric restriction or aerobic exercise training on peak oxygen consumption and quality of life in obese older patients with heart failure with preserved ejection fraction: a randomized clinical trial. JAMA. 2016;315(1):36–46.PubMedPubMedCentralCrossRef Kitzman DW, Brubaker P, Morgan T, et al. Effect of caloric restriction or aerobic exercise training on peak oxygen consumption and quality of life in obese older patients with heart failure with preserved ejection fraction: a randomized clinical trial. JAMA. 2016;315(1):36–46.PubMedPubMedCentralCrossRef
16.
Zurück zum Zitat Warbrick I, Rabkin SW. Hypoxia-inducible factor 1-alpha (HIF-1alpha) as a factor mediating the relationship between obesity and heart failure with preserved ejection fraction. Obes Rev. 2019;20(5):701–12.PubMedCrossRef Warbrick I, Rabkin SW. Hypoxia-inducible factor 1-alpha (HIF-1alpha) as a factor mediating the relationship between obesity and heart failure with preserved ejection fraction. Obes Rev. 2019;20(5):701–12.PubMedCrossRef
17.
Zurück zum Zitat Kessler EL, Oerlemans MIFJ, van den Hoogen P, Yap C, Sluijter JPG, de Jager SCA. Immunomodulation in heart failure with preserved ejection fraction: current state and future perspectives. J Cardiovasc Transl Res. 2021;14(1):63–74.PubMedCrossRef Kessler EL, Oerlemans MIFJ, van den Hoogen P, Yap C, Sluijter JPG, de Jager SCA. Immunomodulation in heart failure with preserved ejection fraction: current state and future perspectives. J Cardiovasc Transl Res. 2021;14(1):63–74.PubMedCrossRef
18.
Zurück zum Zitat Savji N, Meijers WC, Bartz TM, et al. The association of obesity and cardiometabolic traits with incident HFpEF and HFrEF. JACC: Heart Fail. 2018;6(8):701–9.PubMed Savji N, Meijers WC, Bartz TM, et al. The association of obesity and cardiometabolic traits with incident HFpEF and HFrEF. JACC: Heart Fail. 2018;6(8):701–9.PubMed
23.
Zurück zum Zitat Bustamante M, Garate-Carrillo A, Ito BR, et al. Unmasking of oestrogen-dependent changes in left ventricular structure and function in aged female rats: a potential model for pre-heart failure with preserved ejection fraction. J Physiol. 2019;597(7):1805–17.PubMedPubMedCentralCrossRef Bustamante M, Garate-Carrillo A, Ito BR, et al. Unmasking of oestrogen-dependent changes in left ventricular structure and function in aged female rats: a potential model for pre-heart failure with preserved ejection fraction. J Physiol. 2019;597(7):1805–17.PubMedPubMedCentralCrossRef
25.
28.
Zurück zum Zitat Gandhi PU, Gaggin HK, Redfield MM, et al. Insulin-like growth factor-binding protein-7 as a biomarker of diastolic dysfunction and functional capacity in heart failure with preserved ejection fraction: results from the RELAX trial. JACC: Heart Fail. 2016;4(11):860–9.PubMed Gandhi PU, Gaggin HK, Redfield MM, et al. Insulin-like growth factor-binding protein-7 as a biomarker of diastolic dysfunction and functional capacity in heart failure with preserved ejection fraction: results from the RELAX trial. JACC: Heart Fail. 2016;4(11):860–9.PubMed
30.
Zurück zum Zitat Pieske B, Tschöpe C, de Boer RA, et al. How to diagnose heart failure with preserved ejection fraction: the HFA-PEFF diagnostic algorithm: a consensus recommendation from the Heart Failure Association (HFA) of the European Society of Cardiology (ESC). Eur Heart J. 2019;40(40):3297–317.PubMedCrossRef Pieske B, Tschöpe C, de Boer RA, et al. How to diagnose heart failure with preserved ejection fraction: the HFA-PEFF diagnostic algorithm: a consensus recommendation from the Heart Failure Association (HFA) of the European Society of Cardiology (ESC). Eur Heart J. 2019;40(40):3297–317.PubMedCrossRef
32.
Zurück zum Zitat Donal E, Lund LH, Oger E, et al. Value of exercise echocardiography in heart failure with preserved ejection fraction: a substudy from the KaRen study. Eur Heart J Cardiovasc Imaging. 2016;17(1):106–13.PubMed Donal E, Lund LH, Oger E, et al. Value of exercise echocardiography in heart failure with preserved ejection fraction: a substudy from the KaRen study. Eur Heart J Cardiovasc Imaging. 2016;17(1):106–13.PubMed
33.
Zurück zum Zitat Belyavskiy E, Morris DA, Url-Michitsch M, et al. Diastolic stress test echocardiography in patients with suspected heart failure with preserved ejection fraction: a pilot study. ESC Heart Fail. 2019;6(1):146–53.PubMedCrossRef Belyavskiy E, Morris DA, Url-Michitsch M, et al. Diastolic stress test echocardiography in patients with suspected heart failure with preserved ejection fraction: a pilot study. ESC Heart Fail. 2019;6(1):146–53.PubMedCrossRef
34.
Zurück zum Zitat Ezzatvar Y, Izquierdo M, Núñez J, Calatayud J, Ramírez-Vélez R, García-Hermoso A. Cardiorespiratory fitness measured with cardiopulmonary exercise testing and mortality in patients with cardiovascular disease: a systematic review and meta-analysis. J Sport Health Sci. 2021;10(6):609–19.PubMedPubMedCentralCrossRef Ezzatvar Y, Izquierdo M, Núñez J, Calatayud J, Ramírez-Vélez R, García-Hermoso A. Cardiorespiratory fitness measured with cardiopulmonary exercise testing and mortality in patients with cardiovascular disease: a systematic review and meta-analysis. J Sport Health Sci. 2021;10(6):609–19.PubMedPubMedCentralCrossRef
36.
Zurück zum Zitat Malhotra R, Bakken K, D’Elia E, Lewis GD. Cardiopulmonary exercise testing in heart failure. JACC: Heart Fail. 2016;4(8):607–16.PubMed Malhotra R, Bakken K, D’Elia E, Lewis GD. Cardiopulmonary exercise testing in heart failure. JACC: Heart Fail. 2016;4(8):607–16.PubMed
38.
Zurück zum Zitat Sorimachi H, Burkhoff D, Verbrugge FH, et al. Obesity, venous capacitance, and venous compliance in heart failure with preserved ejection fraction. Eur J Heart Fail. 2021;23(10):1648–58.PubMedCrossRef Sorimachi H, Burkhoff D, Verbrugge FH, et al. Obesity, venous capacitance, and venous compliance in heart failure with preserved ejection fraction. Eur J Heart Fail. 2021;23(10):1648–58.PubMedCrossRef
39.
Zurück zum Zitat Fudim M, Kaye DM, Borlaug BA, et al. Venous tone and stressed blood volume in heart failure: JACC review topic of the week. J Am Coll Cardiol. 2022;79(18):1858–69.PubMedCrossRef Fudim M, Kaye DM, Borlaug BA, et al. Venous tone and stressed blood volume in heart failure: JACC review topic of the week. J Am Coll Cardiol. 2022;79(18):1858–69.PubMedCrossRef
40.
Zurück zum Zitat Plitt GD, Spring JT, Moulton MJ, Agrawal DK. Mechanisms, diagnosis, and treatment of heart failure with preserved ejection fraction and diastolic dysfunction. Expert Rev Cardiovasc Ther. 2018;16(8):579–89.PubMedPubMedCentralCrossRef Plitt GD, Spring JT, Moulton MJ, Agrawal DK. Mechanisms, diagnosis, and treatment of heart failure with preserved ejection fraction and diastolic dysfunction. Expert Rev Cardiovasc Ther. 2018;16(8):579–89.PubMedPubMedCentralCrossRef
41.
Zurück zum Zitat Seoudy H, von Eberstein M, Frank J, et al. HFA-PEFF score: prognosis in patients with preserved ejection fraction after transcatheter aortic valve implantation. ESC Heart Fail. 2022;9(2):1071–9.PubMedPubMedCentralCrossRef Seoudy H, von Eberstein M, Frank J, et al. HFA-PEFF score: prognosis in patients with preserved ejection fraction after transcatheter aortic valve implantation. ESC Heart Fail. 2022;9(2):1071–9.PubMedPubMedCentralCrossRef
42.
Zurück zum Zitat Sueta D, Yamamoto E, Nishihara T, et al. H2FPEF score as a prognostic value in HFpEF patients. Am J Hypertens. 2019;32(11):1082–90.PubMedCrossRef Sueta D, Yamamoto E, Nishihara T, et al. H2FPEF score as a prognostic value in HFpEF patients. Am J Hypertens. 2019;32(11):1082–90.PubMedCrossRef
43.
Zurück zum Zitat Dzhioeva O, Belyavskiy E. Diagnosis and management of patients with heart failure with preserved ejection fraction (HFpEF): current perspectives and recommendations. Ther Clin Risk Manag. 2020;16:769–85.PubMedPubMedCentralCrossRef Dzhioeva O, Belyavskiy E. Diagnosis and management of patients with heart failure with preserved ejection fraction (HFpEF): current perspectives and recommendations. Ther Clin Risk Manag. 2020;16:769–85.PubMedPubMedCentralCrossRef
44.
Zurück zum Zitat Dubi S, Arbel Y. Large animal models for diastolic dysfunction and diastolic heart failure—a review of the literature. Cardiovasc Pathol. 2010;19(3):147–52.PubMedCrossRef Dubi S, Arbel Y. Large animal models for diastolic dysfunction and diastolic heart failure—a review of the literature. Cardiovasc Pathol. 2010;19(3):147–52.PubMedCrossRef
46.
Zurück zum Zitat Nakajima Y, Ito S, Asakura M, et al. A dipeptidyl peptidase-IV inhibitor improves diastolic dysfunction in Dahl salt-sensitive rats. J Mol Cell Cardiol. 2019;129:257–65.PubMedCrossRef Nakajima Y, Ito S, Asakura M, et al. A dipeptidyl peptidase-IV inhibitor improves diastolic dysfunction in Dahl salt-sensitive rats. J Mol Cell Cardiol. 2019;129:257–65.PubMedCrossRef
47.
Zurück zum Zitat Bowen TS, Eisenkolb S, Drobner J, et al. High-intensity interval training prevents oxidant-mediated diaphragm muscle weakness in hypertensive mice. FASEB J. 2017;31(1):60–71.PubMedCrossRef Bowen TS, Eisenkolb S, Drobner J, et al. High-intensity interval training prevents oxidant-mediated diaphragm muscle weakness in hypertensive mice. FASEB J. 2017;31(1):60–71.PubMedCrossRef
48.
Zurück zum Zitat Khoury EE, Knaney Y, Fokra A, et al. Pulmonary, cardiac and renal distribution of ACE2, furin, TMPRSS2 and ADAM17 in rats with heart failure: potential implication for COVID-19 disease. J Cell Mol Med. 2021;25(8):3840–55.PubMedPubMedCentralCrossRef Khoury EE, Knaney Y, Fokra A, et al. Pulmonary, cardiac and renal distribution of ACE2, furin, TMPRSS2 and ADAM17 in rats with heart failure: potential implication for COVID-19 disease. J Cell Mol Med. 2021;25(8):3840–55.PubMedPubMedCentralCrossRef
49.
Zurück zum Zitat Shang L, Pin L, Zhu S, et al. Plantamajoside attenuates isoproterenol-induced cardiac hypertrophy associated with the HDAC2 and AKT/GSK-3beta signaling pathway. Chem Biol Interact. 2019;307:21–8.PubMedCrossRef Shang L, Pin L, Zhu S, et al. Plantamajoside attenuates isoproterenol-induced cardiac hypertrophy associated with the HDAC2 and AKT/GSK-3beta signaling pathway. Chem Biol Interact. 2019;307:21–8.PubMedCrossRef
50.
Zurück zum Zitat Goto K, Schauer A, Augstein A, et al. Muscular changes in animal models of heart failure with preserved ejection fraction: what comes closest to the patient? ESC Heart Fail. 2021;8(1):139–50.PubMedCrossRef Goto K, Schauer A, Augstein A, et al. Muscular changes in animal models of heart failure with preserved ejection fraction: what comes closest to the patient? ESC Heart Fail. 2021;8(1):139–50.PubMedCrossRef
52.
Zurück zum Zitat Lam CS, Donal E, Kraigher-Krainer E, Vasan RS. Epidemiology and clinical course of heart failure with preserved ejection fraction. Eur J Heart Fail. 2011;13(1):18–28.PubMedCrossRef Lam CS, Donal E, Kraigher-Krainer E, Vasan RS. Epidemiology and clinical course of heart failure with preserved ejection fraction. Eur J Heart Fail. 2011;13(1):18–28.PubMedCrossRef
53.
Zurück zum Zitat Valero-Muñoz M, Backman W, Sam F. Murine models of heart failure with preserved ejection fraction: a “fishing expedition.” JACC: Basic to Transl Sci. 2017;2(6):770–89. Valero-Muñoz M, Backman W, Sam F. Murine models of heart failure with preserved ejection fraction: a “fishing expedition.” JACC: Basic to Transl Sci. 2017;2(6):770–89.
54.
Zurück zum Zitat Schiattarella GG, Altamirano F, Tong D, et al. Nitrosative stress drives heart failure with preserved ejection fraction. Nature. 2019;568(7752):351–6.PubMedPubMedCentralCrossRef Schiattarella GG, Altamirano F, Tong D, et al. Nitrosative stress drives heart failure with preserved ejection fraction. Nature. 2019;568(7752):351–6.PubMedPubMedCentralCrossRef
55.
Zurück zum Zitat Koch SE, Haworth KJ, Robbins N, et al. Age- and gender-related changes in ventricular performance in wild-type FVB/N mice as evaluated by conventional and vector velocity echocardiography imaging: a retrospective study. Ultrasound Med Biol. 2013;39(11):2034–43.PubMedPubMedCentralCrossRef Koch SE, Haworth KJ, Robbins N, et al. Age- and gender-related changes in ventricular performance in wild-type FVB/N mice as evaluated by conventional and vector velocity echocardiography imaging: a retrospective study. Ultrasound Med Biol. 2013;39(11):2034–43.PubMedPubMedCentralCrossRef
56.
Zurück zum Zitat Karuppagounder V, Arumugam S, Babu SS, et al. The senescence accelerated mouse prone 8 (SAMP8): a novel murine model for cardiac aging. Ageing Res Rev. 2017;35:291–6.PubMedCrossRef Karuppagounder V, Arumugam S, Babu SS, et al. The senescence accelerated mouse prone 8 (SAMP8): a novel murine model for cardiac aging. Ageing Res Rev. 2017;35:291–6.PubMedCrossRef
57.
Zurück zum Zitat Charles CJ, Lee P, Li RR, et al. A porcine model of heart failure with preserved ejection fraction: magnetic resonance imaging and metabolic energetics. ESC Heart Fail. 2020;7(1):92–102.PubMed Charles CJ, Lee P, Li RR, et al. A porcine model of heart failure with preserved ejection fraction: magnetic resonance imaging and metabolic energetics. ESC Heart Fail. 2020;7(1):92–102.PubMed
60.
Zurück zum Zitat Munagala VK, Hart CY, Burnett JC Jr, Meyer DM, Redfield MM. Ventricular structure and function in aged dogs with renal hypertension: a model of experimental diastolic heart failure. Circulation. 2005;111(9):1128–35.PubMedPubMedCentralCrossRef Munagala VK, Hart CY, Burnett JC Jr, Meyer DM, Redfield MM. Ventricular structure and function in aged dogs with renal hypertension: a model of experimental diastolic heart failure. Circulation. 2005;111(9):1128–35.PubMedPubMedCentralCrossRef
61.
Zurück zum Zitat Bei Y, Wang L, Ding R, et al. Animal exercise studies in cardiovascular research: current knowledge and optimal design—a position paper of the Committee on Cardiac Rehabilitation, Chinese Medical Doctors’ Association. J Sport Health Sci. 2021;10(6):660–74.PubMedPubMedCentralCrossRef Bei Y, Wang L, Ding R, et al. Animal exercise studies in cardiovascular research: current knowledge and optimal design—a position paper of the Committee on Cardiac Rehabilitation, Chinese Medical Doctors’ Association. J Sport Health Sci. 2021;10(6):660–74.PubMedPubMedCentralCrossRef
62.
Zurück zum Zitat Edelmann F, Gelbrich G, Düngen HD, et al. Exercise training improves exercise capacity and diastolic function in patients with heart failure with preserved ejection fraction: results of the Ex-DHF (exercise training in diastolic heart failure) pilot study. J Am Coll Cardiol 2011;58(17):1780–91. Edelmann F, Gelbrich G, Düngen HD, et al. Exercise training improves exercise capacity and diastolic function in patients with heart failure with preserved ejection fraction: results of the Ex-DHF (exercise training in diastolic heart failure) pilot study. J Am Coll Cardiol 2011;58(17):1780–91.
63.
Zurück zum Zitat Kitzman DW, Brubaker PH, Herrington DM, et al. Effect of endurance exercise training on endothelial function and arterial stiffness in older patients with heart failure and preserved ejection fraction: a randomized, controlled, single-blind trial. J Am Coll Cardiol. 2013;62(7):584–92.PubMedPubMedCentralCrossRef Kitzman DW, Brubaker PH, Herrington DM, et al. Effect of endurance exercise training on endothelial function and arterial stiffness in older patients with heart failure and preserved ejection fraction: a randomized, controlled, single-blind trial. J Am Coll Cardiol. 2013;62(7):584–92.PubMedPubMedCentralCrossRef
64.
Zurück zum Zitat Houstis NE, Eisman AS, Pappagianopoulos PP, et al. Exercise intolerance in heart failure with preserved ejection fraction: diagnosing and ranking its causes using personalized O2 pathway analysis. Circulation. 2018;137(2):148–61.PubMedCrossRef Houstis NE, Eisman AS, Pappagianopoulos PP, et al. Exercise intolerance in heart failure with preserved ejection fraction: diagnosing and ranking its causes using personalized O2 pathway analysis. Circulation. 2018;137(2):148–61.PubMedCrossRef
65.
Zurück zum Zitat Guo J, Wang Z, Wu J, et al. Endothelial SIRT6 is vital to prevent hypertension and associated cardiorenal injury through targeting Nkx3.2-GATA5 signaling. Circ Res. 2019;124(10):1448–61.PubMedCrossRef Guo J, Wang Z, Wu J, et al. Endothelial SIRT6 is vital to prevent hypertension and associated cardiorenal injury through targeting Nkx3.2-GATA5 signaling. Circ Res. 2019;124(10):1448–61.PubMedCrossRef
66.
Zurück zum Zitat Gladden JD, Chaanine AH, Redfield MM. Heart failure with preserved ejection fraction. Annu Rev Med. 2018;69:65–79.PubMedCrossRef Gladden JD, Chaanine AH, Redfield MM. Heart failure with preserved ejection fraction. Annu Rev Med. 2018;69:65–79.PubMedCrossRef
68.
Zurück zum Zitat Bowen TS, Rolim NP, Fischer T, et al. Heart failure with preserved ejection fraction induces molecular, mitochondrial, histological, and functional alterations in rat respiratory and limb skeletal muscle. Eur J Heart Fail. 2015;17(3):263–72.PubMedCrossRef Bowen TS, Rolim NP, Fischer T, et al. Heart failure with preserved ejection fraction induces molecular, mitochondrial, histological, and functional alterations in rat respiratory and limb skeletal muscle. Eur J Heart Fail. 2015;17(3):263–72.PubMedCrossRef
70.
Zurück zum Zitat Adams V, Alves M, Fischer T, et al. High-intensity interval training attenuates endothelial dysfunction in a Dahl salt-sensitive rat model of heart failure with preserved ejection fraction. J Appl Physiol(1985). 2015;119(6):745–52.PubMedCrossRef Adams V, Alves M, Fischer T, et al. High-intensity interval training attenuates endothelial dysfunction in a Dahl salt-sensitive rat model of heart failure with preserved ejection fraction. J Appl Physiol(1985). 2015;119(6):745–52.PubMedCrossRef
71.
Zurück zum Zitat Schmederer Z, Rolim N, Bowen TS, et al. Endothelial function is disturbed in a hypertensive diabetic animal model of HFpEF: moderate continuous vs. high intensity interval training. Int J Cardiol. 2018;273:147–54.PubMedCrossRef Schmederer Z, Rolim N, Bowen TS, et al. Endothelial function is disturbed in a hypertensive diabetic animal model of HFpEF: moderate continuous vs. high intensity interval training. Int J Cardiol. 2018;273:147–54.PubMedCrossRef
72.
Zurück zum Zitat Shen X, Tan Z, Zhong X, et al. Endocardial endothelium is a key determinant of force-frequency relationship in rat ventricular myocardium. J Appl Physiol(1985). 2013;115(3):383–93.PubMedCrossRef Shen X, Tan Z, Zhong X, et al. Endocardial endothelium is a key determinant of force-frequency relationship in rat ventricular myocardium. J Appl Physiol(1985). 2013;115(3):383–93.PubMedCrossRef
74.
Zurück zum Zitat Sandri M, Viehmann M, Adams V, et al. Chronic heart failure and aging — effects of exercise training on endothelial function and mechanisms of endothelial regeneration: results from the Leipzig Exercise Intervention in Chronic heart failure and Aging (LEICA) study. Eur J Prev Cardiol. 2016;23(4):349–58.PubMedCrossRef Sandri M, Viehmann M, Adams V, et al. Chronic heart failure and aging — effects of exercise training on endothelial function and mechanisms of endothelial regeneration: results from the Leipzig Exercise Intervention in Chronic heart failure and Aging (LEICA) study. Eur J Prev Cardiol. 2016;23(4):349–58.PubMedCrossRef
75.
Zurück zum Zitat Machado MV, Martins RL, Borges J, et al. Exercise training reverses structural microvascular rarefaction and improves endothelium-dependent microvascular reactivity in rats with diabetes. Metab Syndr Relat Disord. 2016;14(6):298–304.PubMedCrossRef Machado MV, Martins RL, Borges J, et al. Exercise training reverses structural microvascular rarefaction and improves endothelium-dependent microvascular reactivity in rats with diabetes. Metab Syndr Relat Disord. 2016;14(6):298–304.PubMedCrossRef
76.
Zurück zum Zitat Machado MV, Vieira AB, da Conceição FG, Nascimento AR, da Nóbrega ACL, Tibirica E. Exercise training dose differentially alters muscle and heart capillary density and metabolic functions in an obese rat with metabolic syndrome. Exp Physiol. 2017;102(12):1716–28.PubMedCrossRef Machado MV, Vieira AB, da Conceição FG, Nascimento AR, da Nóbrega ACL, Tibirica E. Exercise training dose differentially alters muscle and heart capillary density and metabolic functions in an obese rat with metabolic syndrome. Exp Physiol. 2017;102(12):1716–28.PubMedCrossRef
78.
Zurück zum Zitat Wang L, Wang J, Cretoiu D, Li G, Xiao J. Exercise-mediated regulation of autophagy in the cardiovascular system. J Sport Health Sci. 2020;9(3):203–10.PubMedCrossRef Wang L, Wang J, Cretoiu D, Li G, Xiao J. Exercise-mediated regulation of autophagy in the cardiovascular system. J Sport Health Sci. 2020;9(3):203–10.PubMedCrossRef
79.
Zurück zum Zitat van Heerebeek L, Hamdani N, Falcão-Pires I, et al. Low myocardial protein kinase G activity in heart failure with preserved ejection fraction. Circulation. 2012;126(7):830–9.PubMedCrossRef van Heerebeek L, Hamdani N, Falcão-Pires I, et al. Low myocardial protein kinase G activity in heart failure with preserved ejection fraction. Circulation. 2012;126(7):830–9.PubMedCrossRef
80.
Zurück zum Zitat Slater RE, Strom JG, Granzier H. Effect of exercise on passive myocardial stiffness in mice with diastolic dysfunction. J Mol Cell Cardiol. 2017;108:24–33.PubMedCrossRef Slater RE, Strom JG, Granzier H. Effect of exercise on passive myocardial stiffness in mice with diastolic dysfunction. J Mol Cell Cardiol. 2017;108:24–33.PubMedCrossRef
81.
Zurück zum Zitat Hidalgo C, Saripalli C, Granzier HL. Effect of exercise training on post-translational and post-transcriptional regulation of titin stiffness in striated muscle of wild type and IG KO mice. Arch Biochem Biophys. 2014;552–553:100–7.PubMedCrossRef Hidalgo C, Saripalli C, Granzier HL. Effect of exercise training on post-translational and post-transcriptional regulation of titin stiffness in striated muscle of wild type and IG KO mice. Arch Biochem Biophys. 2014;552–553:100–7.PubMedCrossRef
83.
Zurück zum Zitat Dong S, Ma W, Hao B, et al. microRNA-21 promotes cardiac fibrosis and development of heart failure with preserved left ventricular ejection fraction by up-regulating Bcl-2. Int J Clin Exp Pathol. 2014;7(2):565–74.PubMedPubMedCentral Dong S, Ma W, Hao B, et al. microRNA-21 promotes cardiac fibrosis and development of heart failure with preserved left ventricular ejection fraction by up-regulating Bcl-2. Int J Clin Exp Pathol. 2014;7(2):565–74.PubMedPubMedCentral
84.
Zurück zum Zitat Alves JP, Nunes RB, Ferreira DDC, Stefani GP, Jaenisch RB, Lago PD. High-intensity resistance training alone or combined with aerobic training improves strength, heart function and collagen in rats with heart failure. Am J Transl Res. 2017;9(12):5432–41.PubMedPubMedCentral Alves JP, Nunes RB, Ferreira DDC, Stefani GP, Jaenisch RB, Lago PD. High-intensity resistance training alone or combined with aerobic training improves strength, heart function and collagen in rats with heart failure. Am J Transl Res. 2017;9(12):5432–41.PubMedPubMedCentral
86.
Zurück zum Zitat Lee Y, Kwak HB, Hord J, Kim JH, Lawler JM. Exercise training attenuates age-dependent elevation of angiotensin II type 1 receptor and Nox2 signaling in the rat heart. Exp Gerontol. 2015;70:163–73.PubMedCrossRef Lee Y, Kwak HB, Hord J, Kim JH, Lawler JM. Exercise training attenuates age-dependent elevation of angiotensin II type 1 receptor and Nox2 signaling in the rat heart. Exp Gerontol. 2015;70:163–73.PubMedCrossRef
87.
Zurück zum Zitat Hieda M, Sarma S, Hearon CM Jr, et al. One-year committed exercise training reverses abnormal left ventricular myocardial stiffness in patients with stage B heart failure with preserved ejection fraction. Circulation. 2021;144(12):934–46.PubMedPubMedCentralCrossRef Hieda M, Sarma S, Hearon CM Jr, et al. One-year committed exercise training reverses abnormal left ventricular myocardial stiffness in patients with stage B heart failure with preserved ejection fraction. Circulation. 2021;144(12):934–46.PubMedPubMedCentralCrossRef
88.
Zurück zum Zitat Johnson EJ, Dieter BP, Marsh SA. Evidence for distinct effects of exercise in different cardiac hypertrophic disorders. Life Sci. 2015;123:100–6.PubMedCrossRef Johnson EJ, Dieter BP, Marsh SA. Evidence for distinct effects of exercise in different cardiac hypertrophic disorders. Life Sci. 2015;123:100–6.PubMedCrossRef
89.
Zurück zum Zitat Fujimoto N, Prasad A, Hastings JL, et al. Cardiovascular effects of 1 year of progressive endurance exercise training in patients with heart failure with preserved ejection fraction. Am Heart J. 2012;164(6):869–77.PubMedCrossRef Fujimoto N, Prasad A, Hastings JL, et al. Cardiovascular effects of 1 year of progressive endurance exercise training in patients with heart failure with preserved ejection fraction. Am Heart J. 2012;164(6):869–77.PubMedCrossRef
90.
Zurück zum Zitat Heinzel FR, Hohendanner F, Jin G, Sedej S, Edelmann F. Myocardial hypertrophy and its role in heart failure with preserved ejection fraction. J Appl Physiol(1985). 2015;119(10):1233–42.PubMedCrossRef Heinzel FR, Hohendanner F, Jin G, Sedej S, Edelmann F. Myocardial hypertrophy and its role in heart failure with preserved ejection fraction. J Appl Physiol(1985). 2015;119(10):1233–42.PubMedCrossRef
91.
92.
Zurück zum Zitat Tong D, Schiattarella GG, Jiang N, et al. NAD(+) repletion reverses heart failure with preserved ejection fraction. Circ Res. 2021;128(11):1629–41.PubMedPubMedCentralCrossRef Tong D, Schiattarella GG, Jiang N, et al. NAD(+) repletion reverses heart failure with preserved ejection fraction. Circ Res. 2021;128(11):1629–41.PubMedPubMedCentralCrossRef
94.
Zurück zum Zitat Campion D, Charbonnier C, Nicolas G. SORL1 genetic variants and Alzheimer disease risk: a literature review and meta-analysis of sequencing data. Acta Neuropathol. 2019;138(2):173–86.PubMedCrossRef Campion D, Charbonnier C, Nicolas G. SORL1 genetic variants and Alzheimer disease risk: a literature review and meta-analysis of sequencing data. Acta Neuropathol. 2019;138(2):173–86.PubMedCrossRef
95.
Zurück zum Zitat Ma QL, Galasko DR, Ringman JM, et al. Reduction of SorLA/LR11, a sorting protein limiting beta-amyloid production, in Alzheimer disease cerebrospinal fluid. Arch Neurol. 2009;66(4):448–57.PubMedPubMedCentralCrossRef Ma QL, Galasko DR, Ringman JM, et al. Reduction of SorLA/LR11, a sorting protein limiting beta-amyloid production, in Alzheimer disease cerebrospinal fluid. Arch Neurol. 2009;66(4):448–57.PubMedPubMedCentralCrossRef
96.
Zurück zum Zitat Nowak KJ, Wattanasirichaigoon D, Goebel HH, et al. Mutations in the skeletal muscle alpha-actin gene in patients with actin myopathy and nemaline myopathy. Nat Genet. 1999;23(2):208–12.PubMedCrossRef Nowak KJ, Wattanasirichaigoon D, Goebel HH, et al. Mutations in the skeletal muscle alpha-actin gene in patients with actin myopathy and nemaline myopathy. Nat Genet. 1999;23(2):208–12.PubMedCrossRef
98.
Zurück zum Zitat Papademetriou V, Toumpourleka M, Imprialos KP, Alataki S, Manafis A, Stavropoulos K. The role of mineralocorticoid receptor antagonists in heart failure with reduced ejection fraction. Curr Pharm Des. 2018;24(46):5517–24.PubMedCrossRef Papademetriou V, Toumpourleka M, Imprialos KP, Alataki S, Manafis A, Stavropoulos K. The role of mineralocorticoid receptor antagonists in heart failure with reduced ejection fraction. Curr Pharm Des. 2018;24(46):5517–24.PubMedCrossRef
99.
Zurück zum Zitat Qamer SZ, Malik A, Bayoumi E, et al. Digoxin use and outcomes in patients with heart failure with reduced ejection fraction. Am J Med. 2019;132(11):1311–9.PubMedCrossRef Qamer SZ, Malik A, Bayoumi E, et al. Digoxin use and outcomes in patients with heart failure with reduced ejection fraction. Am J Med. 2019;132(11):1311–9.PubMedCrossRef
100.
Zurück zum Zitat Ilieșiu AM, Hodorogea AS. Treatment of heart failure with preserved ejection fraction. Adv Exp Med Biol. 2018;1067:67–87.PubMedCrossRef Ilieșiu AM, Hodorogea AS. Treatment of heart failure with preserved ejection fraction. Adv Exp Med Biol. 2018;1067:67–87.PubMedCrossRef
101.
Zurück zum Zitat Oelze M, Knorr M, Kröller-Schön S, et al. Chronic therapy with isosorbide-5-mononitrate causes endothelial dysfunction, oxidative stress, and a marked increase in vascular endothelin-1 expression. Eur Heart J. 2013;34(41):3206–16.PubMedCrossRef Oelze M, Knorr M, Kröller-Schön S, et al. Chronic therapy with isosorbide-5-mononitrate causes endothelial dysfunction, oxidative stress, and a marked increase in vascular endothelin-1 expression. Eur Heart J. 2013;34(41):3206–16.PubMedCrossRef
103.
Zurück zum Zitat Borlaug BA, Anstrom KJ, Lewis GD, et al. Effect of inorganic nitrite vs placebo on exercise capacity among patients with heart failure with preserved ejection fraction: the INDIE-HFpEF randomized clinical trial. J Am Med Assoc. 2018;320(17):1764–73.CrossRef Borlaug BA, Anstrom KJ, Lewis GD, et al. Effect of inorganic nitrite vs placebo on exercise capacity among patients with heart failure with preserved ejection fraction: the INDIE-HFpEF randomized clinical trial. J Am Med Assoc. 2018;320(17):1764–73.CrossRef
104.
Zurück zum Zitat Pieske B, Maggioni AP, Lam CSP, et al. Vericiguat in patients with worsening chronic heart failure and preserved ejection fraction: results of the SOluble guanylate Cyclase stimulatoR in heArT failurE patientS with PRESERVED EF (SOCRATES-PRESERVED) study. Eur Heart J. 2017;38(15):1119–27.PubMedPubMedCentralCrossRef Pieske B, Maggioni AP, Lam CSP, et al. Vericiguat in patients with worsening chronic heart failure and preserved ejection fraction: results of the SOluble guanylate Cyclase stimulatoR in heArT failurE patientS with PRESERVED EF (SOCRATES-PRESERVED) study. Eur Heart J. 2017;38(15):1119–27.PubMedPubMedCentralCrossRef
105.
Zurück zum Zitat Armstrong PW, Lam CSP, Anstrom KJ, et al. Effect of vericiguat vs placebo on quality of life in patients with heart failure and preserved ejection fraction: the VITALITY-HFpEF randomized clinical trial. J Am Med Assoc. 2020;324(15):1512–21.CrossRef Armstrong PW, Lam CSP, Anstrom KJ, et al. Effect of vericiguat vs placebo on quality of life in patients with heart failure and preserved ejection fraction: the VITALITY-HFpEF randomized clinical trial. J Am Med Assoc. 2020;324(15):1512–21.CrossRef
106.
Zurück zum Zitat Redfield MM, Borlaug BA, Lewis GD, et al. PhosphdiesteRasE-5 inhibition to improve clinical status and exercise capacity in diastolic heart failure (RELAX) trial: rationale and design. Circ Heart Fail. 2012;5(5):653–9.PubMedPubMedCentralCrossRef Redfield MM, Borlaug BA, Lewis GD, et al. PhosphdiesteRasE-5 inhibition to improve clinical status and exercise capacity in diastolic heart failure (RELAX) trial: rationale and design. Circ Heart Fail. 2012;5(5):653–9.PubMedPubMedCentralCrossRef
107.
Zurück zum Zitat Redfield MM, Chen HH, Borlaug BA, et al. Effect of phosphodiesterase-5 inhibition on exercise capacity and clinical status in heart failure with preserved ejection fraction: a randomized clinical trial. J Am Med Assoc. 2013;309(12):1268–77.CrossRef Redfield MM, Chen HH, Borlaug BA, et al. Effect of phosphodiesterase-5 inhibition on exercise capacity and clinical status in heart failure with preserved ejection fraction: a randomized clinical trial. J Am Med Assoc. 2013;309(12):1268–77.CrossRef
108.
Zurück zum Zitat Yancy CW, Jessup M, Bozkurt B, et al. 2017 ACC/AHA/HFSA focused update of the 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. J Cardiac Fail. 2017;23(8):628–51.CrossRef Yancy CW, Jessup M, Bozkurt B, et al. 2017 ACC/AHA/HFSA focused update of the 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. J Cardiac Fail. 2017;23(8):628–51.CrossRef
112.
Zurück zum Zitat Fudim M, Kelly JP, Brophy TJ, et al. Trends in treatment for patients hospitalized with heart failure with preserved ejection fraction before and after treatment of preserved cardiac function heart failure with an aldosterone antagonist (TOPCAT). Am J Cardiol. 2020;125(11):1655–60.PubMedCrossRef Fudim M, Kelly JP, Brophy TJ, et al. Trends in treatment for patients hospitalized with heart failure with preserved ejection fraction before and after treatment of preserved cardiac function heart failure with an aldosterone antagonist (TOPCAT). Am J Cardiol. 2020;125(11):1655–60.PubMedCrossRef
113.
Zurück zum Zitat Belkin MN, Blair JE, Shah SJ, Alenghat FJ. A composite metric for predicting benefit from spironolactone in heart failure with preserved ejection fraction. ESC Heart Fail. 2021;8(5):3495–503.PubMedPubMedCentralCrossRef Belkin MN, Blair JE, Shah SJ, Alenghat FJ. A composite metric for predicting benefit from spironolactone in heart failure with preserved ejection fraction. ESC Heart Fail. 2021;8(5):3495–503.PubMedPubMedCentralCrossRef
115.
Zurück zum Zitat Packer M, Anker SD, Butler J, et al. Empagliflozin in patients with heart failure, reduced ejection fraction, and volume overload: EMPEROR-reduced trial. J Am Coll Cardiol. 2021;77(11):1381–92.PubMedCrossRef Packer M, Anker SD, Butler J, et al. Empagliflozin in patients with heart failure, reduced ejection fraction, and volume overload: EMPEROR-reduced trial. J Am Coll Cardiol. 2021;77(11):1381–92.PubMedCrossRef
117.
Zurück zum Zitat Vashi R, Patel BM. NRF2 in cardiovascular diseases: a ray of hope! J Cardiovasc Transl Res. 2021;14(3):573–86.PubMedCrossRef Vashi R, Patel BM. NRF2 in cardiovascular diseases: a ray of hope! J Cardiovasc Transl Res. 2021;14(3):573–86.PubMedCrossRef
118.
Zurück zum Zitat Xia Q, Campbell JA, Ahmad H, Si L, de Graaff B, Palmer AJ. Bariatric surgery is a cost-saving treatment for obesity—a comprehensive meta-analysis and updated systematic review of health economic evaluations of bariatric surgery. Obes Rev. 2020;21(1):e12932. https://doi.org/10.1111/obr.12932.CrossRefPubMed Xia Q, Campbell JA, Ahmad H, Si L, de Graaff B, Palmer AJ. Bariatric surgery is a cost-saving treatment for obesity—a comprehensive meta-analysis and updated systematic review of health economic evaluations of bariatric surgery. Obes Rev. 2020;21(1):e12932. https://​doi.​org/​10.​1111/​obr.​12932.CrossRefPubMed
120.
Zurück zum Zitat Wilding JPH, Batterham RL, Calanna S, et al. Once-weekly semaglutide in adults with overweight or obesity. N Engl J Med. 2021;384(11):989–1002.PubMedCrossRef Wilding JPH, Batterham RL, Calanna S, et al. Once-weekly semaglutide in adults with overweight or obesity. N Engl J Med. 2021;384(11):989–1002.PubMedCrossRef
121.
Zurück zum Zitat Davies M, Færch L, Jeppesen OK, et al. Semaglutide 2.4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomised, double-blind, double-dummy, placebo-controlled, phase 3 trial. Lancet. 2021;397(10278):971–84.PubMedCrossRef Davies M, Færch L, Jeppesen OK, et al. Semaglutide 2.4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomised, double-blind, double-dummy, placebo-controlled, phase 3 trial. Lancet. 2021;397(10278):971–84.PubMedCrossRef
122.
Zurück zum Zitat Wadden TA, Bailey TS, Billings LK, et al. Effect of subcutaneous semaglutide vs placebo as an adjunct to intensive behavioral therapy on body weight in adults with overweight or obesity: the STEP 3 randomized clinical trial. J Am Med Assoc. 2021;325(14):1403–13.CrossRef Wadden TA, Bailey TS, Billings LK, et al. Effect of subcutaneous semaglutide vs placebo as an adjunct to intensive behavioral therapy on body weight in adults with overweight or obesity: the STEP 3 randomized clinical trial. J Am Med Assoc. 2021;325(14):1403–13.CrossRef
123.
Zurück zum Zitat Rubino D, Abrahamsson N, Davies M, et al. Effect of continued weekly subcutaneous semaglutide vs placebo on weight loss maintenance in adults with overweight or obesity: the STEP 4 randomized clinical trial. J Am Med Assoc. 2021;325(14):1414–25.CrossRef Rubino D, Abrahamsson N, Davies M, et al. Effect of continued weekly subcutaneous semaglutide vs placebo on weight loss maintenance in adults with overweight or obesity: the STEP 4 randomized clinical trial. J Am Med Assoc. 2021;325(14):1414–25.CrossRef
124.
Zurück zum Zitat Bakbak E, Terenzi DC, Trac JZ, et al. Lessons from bariatric surgery: can increased GLP-1 enhance vascular repair during cardiometabolic-based chronic disease? Rev Endocr Metab Disord. 2021;22(4):1171–88.PubMedCrossRef Bakbak E, Terenzi DC, Trac JZ, et al. Lessons from bariatric surgery: can increased GLP-1 enhance vascular repair during cardiometabolic-based chronic disease? Rev Endocr Metab Disord. 2021;22(4):1171–88.PubMedCrossRef
126.
Zurück zum Zitat Adamopoulos S, Parissis J, Kroupis C, et al. Physical training reduces peripheral markers of inflammation in patients with chronic heart failure. Eur Heart J. 2001;22(9):791–7.PubMedCrossRef Adamopoulos S, Parissis J, Kroupis C, et al. Physical training reduces peripheral markers of inflammation in patients with chronic heart failure. Eur Heart J. 2001;22(9):791–7.PubMedCrossRef
128.
Zurück zum Zitat Church TS, Earnest CP, Skinner JS, Blair SN. Effects of different doses of physical activity on cardiorespiratory fitness among sedentary, overweight or obese postmenopausal women with elevated blood pressure: a randomized controlled trial. JAMA. 2007;297(19):2081–91.PubMedCrossRef Church TS, Earnest CP, Skinner JS, Blair SN. Effects of different doses of physical activity on cardiorespiratory fitness among sedentary, overweight or obese postmenopausal women with elevated blood pressure: a randomized controlled trial. JAMA. 2007;297(19):2081–91.PubMedCrossRef
Metadaten
Titel
Heart Failure with Preserved Ejection Fraction: Pathogenesis, Diagnosis, Exercise, and Medical Therapies
verfasst von
Qingyi Zhan
Wenjing Peng
Siqi Wang
Juan Gao
Publikationsdatum
28.09.2022
Verlag
Springer US
Erschienen in
Journal of Cardiovascular Translational Research / Ausgabe 2/2023
Print ISSN: 1937-5387
Elektronische ISSN: 1937-5395
DOI
https://doi.org/10.1007/s12265-022-10324-y

Weitere Artikel der Ausgabe 2/2023

Journal of Cardiovascular Translational Research 2/2023 Zur Ausgabe

Schadet Ärger den Gefäßen?

14.05.2024 Arteriosklerose Nachrichten

In einer Studie aus New York wirkte sich Ärger kurzfristig deutlich negativ auf die Endothelfunktion gesunder Probanden aus. Möglicherweise hat dies Einfluss auf die kardiovaskuläre Gesundheit.

Intervallfasten zur Regeneration des Herzmuskels?

14.05.2024 Herzinfarkt Nachrichten

Die Nahrungsaufnahme auf wenige Stunden am Tag zu beschränken, hat möglicherweise einen günstigen Einfluss auf die Prognose nach akutem ST-Hebungsinfarkt. Darauf deutet eine Studie an der Uniklinik in Halle an der Saale hin.

Shunt-Therapie bei Herzinsuffizienz: Kein Anzug, der allen passt

13.05.2024 Chronische Herzinsuffizienz Nachrichten

Die Anlage eines interatrialen Shunts zur Reduktion des linksatrialen Drucks ist ein neuer Therapieansatz bei Herzinsuffizienz. Viele Patienten sprechen darauf an, andere jedoch nicht. 

Vorsicht, erhöhte Blutungsgefahr nach PCI!

10.05.2024 Koronare Herzerkrankung Nachrichten

Nach PCI besteht ein erhöhtes Blutungsrisiko, wenn die Behandelten eine verminderte linksventrikuläre Ejektionsfraktion aufweisen. Das Risiko ist umso höher, je stärker die Pumpfunktion eingeschränkt ist.

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.