Left Ventricular Ejection Fraction and the Future of Heart Failure Phenotyping

被引：10

作者：

Dimond, Matthew G. ^{[1
]}

Ibrahim, Nasrien E. ^{[1
]}

Fiuzat, Mona ^{[2
]}

McMurray, John J. V. ^{[3
]}

Lindenfeld, Joann ^{[4
]}

Ahmad, Tariq ^{[5
]}

Bozkurt, Biykem ^{[6
]}

Bristow, Michael R. ^{[7
]}

Butler, Javed ^{[8
]}

Carson, Peter E. ^{[9
]}

Felker, G. Michael ^{[2
]}

Jessup, Mariell ^{[10
]}

Murillo, Jaime ^{[11
]}

Kondo, Toru ^{[3
,12
]}

Solomon, Scott D. ^{[13
]}

Abraham, William T. ^{[14
]}

O'Connor, Christopher M. ^{[1
,2
]}

Psotka, Mitchell A. ^{[1
]}

机构：

[1] Inova Schar Heart & Vasc, 3300 Gallows Rd, Falls Church, VA 22042 USA

[2] Duke Univ, Med Ctr, Durham, NC USA

[3] Univ Glasgow, British Heart Fdn, Cardiovasc Res Ctr, Glasgow, Scotland

[4] Vanderbilt Univ, Sch Med, Nashville, TN USA

[5] Yale Univ, Sch Med, New Haven, CT USA

[6] Baylor Coll Med, Houston, TX USA

[7] Univ Colorado Anschutz, Sch Med, Aurora, CO USA

[8] Baylor Scott & White Res Inst, Dallas, TX USA

[9] VA Med Ctr, Washington, DC USA

[10] Amer Heart Assoc, Dallas, TX USA

[11] UnitedHlth Grp, Ft Lauderdale, FL 33301 USA

[12] Nagoya Univ, Grad Sch Med, Dept Cardiol, Nagoya, Japan

[13] Harvard Med Sch, Boston, MA USA

[14] Ohio State Univ, Sch Med, Columbus, OH 43210 USA

来源：

JACC-HEART FAILURE | 2024年 / 12卷 / 03期

关键词：

classification; heart failure; left ventricular ejection fraction; phenotyping; CHAMBER QUANTIFICATION; EUROPEAN ASSOCIATION; SPIRONOLACTONE; ECHOCARDIOGRAPHY; RECOMMENDATIONS; BIOMARKERS; UPDATE; CARE;

D O I：

10.1016/j.jchf.2023.11.005

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Heart failure (HF) is a complex syndrome traditionally classified by left ventricular ejection fraction (LVEF) cutpoints. Although LVEF is prognostic for risk of events and predictive of response to some HF therapies, LVEF is a continuous variable and cutpoints are arbitrary, often based on historical clinical trial enrichment decisions rather than physiology. Holistic evaluation of the treatment effects for therapies throughout the LVEF range suggests the standard categorization paradigm for HF merits modification. The multidisciplinary Heart Failure Collaboratory reviewed data from largescale HF clinical trials and found that many HF therapies have demonstrated therapeutic benefit across a large range of LVEF, but specific treatment effects vary across that range. Therefore, HF should practically be classified by association with an LVEF that is reduced or not reduced, while acknowledging uncertainty around the precise LVEF cutpoint, and future research should evaluate new therapies across the continuum of LVEF. (J Am Coll Cardiol Case Rep 2024;12:451- 460) Published by Elsevier on behalf of the American College of Cardiology Foundation. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

引用

页码：451 / 460

页数：10

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