It is estimated that approximately 50% of the heart failure population has a normal left ventricular ejection fraction, a complex broadly referred to as heart failure with normal left ventricular ejection fraction (HFNEF). While these patients have been considered in epidemiologic studies and clinical trials to represent a single pool of patients, limited more detailed studies indicate that HFNEF patients are a very heterogeneous group, with a number of key pathophysiologic mechanisms. This review summarizes and critically analyzes available data on the pathophysiology of HFNEF, placing it into context with a recently developed diagnostic algorithm. We evaluate the utility of commonly applied echocardiographic measures and biomarkers and integrate mechanistic observations into potential future therapeutic directions. (J Am Coll Cardiol 2009; 53: 905-18) (C) 2009 by the American College of Cardiology Foundation
机构:
Mayo Clin, Div Cardiovasc Dis, Rochester, MN 55905 USA
Mayo Clin, Div Internal Med, Rochester, MN USAMayo Clin, Div Cardiovasc Dis, Rochester, MN 55905 USA
Abhayaratna, Walter P.
;
Fatema, Kaniz
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Mayo Clin, Div Cardiovasc Dis, Rochester, MN 55905 USA
Mayo Clin, Div Internal Med, Rochester, MN USAMayo Clin, Div Cardiovasc Dis, Rochester, MN 55905 USA
Fatema, Kaniz
;
Barnes, Marion E.
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Mayo Clin, Div Cardiovasc Dis, Rochester, MN 55905 USA
Mayo Clin, Div Internal Med, Rochester, MN USAMayo Clin, Div Cardiovasc Dis, Rochester, MN 55905 USA
Barnes, Marion E.
;
Seward, James B.
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Mayo Clin, Div Cardiovasc Dis, Rochester, MN 55905 USA
Mayo Clin, Div Internal Med, Rochester, MN USAMayo Clin, Div Cardiovasc Dis, Rochester, MN 55905 USA
Seward, James B.
;
Gersh, Bernard J.
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Mayo Clin, Div Cardiovasc Dis, Rochester, MN 55905 USA
Mayo Clin, Div Internal Med, Rochester, MN USAMayo Clin, Div Cardiovasc Dis, Rochester, MN 55905 USA
Gersh, Bernard J.
;
Bailey, Kent R.
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Mayo Clin, Div Biostat, Rochester, MN USAMayo Clin, Div Cardiovasc Dis, Rochester, MN 55905 USA
Bailey, Kent R.
;
Casaclang-Verzosa, Grace
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Mayo Clin, Div Cardiovasc Dis, Rochester, MN 55905 USA
Mayo Clin, Div Internal Med, Rochester, MN USAMayo Clin, Div Cardiovasc Dis, Rochester, MN 55905 USA
Casaclang-Verzosa, Grace
;
Tsang, Teresa S. M.
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Mayo Clin, Div Cardiovasc Dis, Rochester, MN 55905 USA
Mayo Clin, Div Internal Med, Rochester, MN USAMayo Clin, Div Cardiovasc Dis, Rochester, MN 55905 USA
机构:Mayo Clin & Mayo Fdn, Div Cardiovasc Dis & Internal Med, Mayo Echocardiog Res Ctr, Rochester, MN 55905 USA
Al-Omari, Malik A.
;
Finstuen, Joshua
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Finstuen, Joshua
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Appleton, Christopher P.
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机构:Mayo Clin & Mayo Fdn, Div Cardiovasc Dis & Internal Med, Mayo Echocardiog Res Ctr, Rochester, MN 55905 USA
Appleton, Christopher P.
;
Barnes, Marion E.
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机构:Mayo Clin & Mayo Fdn, Div Cardiovasc Dis & Internal Med, Mayo Echocardiog Res Ctr, Rochester, MN 55905 USA
Barnes, Marion E.
;
Tsang, Teresa S. M.
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Mayo Clin & Mayo Fdn, Div Cardiovasc Dis & Internal Med, Mayo Echocardiog Res Ctr, Rochester, MN 55905 USAMayo Clin & Mayo Fdn, Div Cardiovasc Dis & Internal Med, Mayo Echocardiog Res Ctr, Rochester, MN 55905 USA
机构:
Mayo Clin, Div Cardiovasc Dis, Rochester, MN 55905 USA
Mayo Clin, Div Internal Med, Rochester, MN USAMayo Clin, Div Cardiovasc Dis, Rochester, MN 55905 USA
Abhayaratna, Walter P.
;
Fatema, Kaniz
论文数: 0引用数: 0
h-index: 0
机构:
Mayo Clin, Div Cardiovasc Dis, Rochester, MN 55905 USA
Mayo Clin, Div Internal Med, Rochester, MN USAMayo Clin, Div Cardiovasc Dis, Rochester, MN 55905 USA
Fatema, Kaniz
;
Barnes, Marion E.
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h-index: 0
机构:
Mayo Clin, Div Cardiovasc Dis, Rochester, MN 55905 USA
Mayo Clin, Div Internal Med, Rochester, MN USAMayo Clin, Div Cardiovasc Dis, Rochester, MN 55905 USA
Barnes, Marion E.
;
Seward, James B.
论文数: 0引用数: 0
h-index: 0
机构:
Mayo Clin, Div Cardiovasc Dis, Rochester, MN 55905 USA
Mayo Clin, Div Internal Med, Rochester, MN USAMayo Clin, Div Cardiovasc Dis, Rochester, MN 55905 USA
Seward, James B.
;
Gersh, Bernard J.
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机构:
Mayo Clin, Div Cardiovasc Dis, Rochester, MN 55905 USA
Mayo Clin, Div Internal Med, Rochester, MN USAMayo Clin, Div Cardiovasc Dis, Rochester, MN 55905 USA
Gersh, Bernard J.
;
Bailey, Kent R.
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机构:
Mayo Clin, Div Biostat, Rochester, MN USAMayo Clin, Div Cardiovasc Dis, Rochester, MN 55905 USA
Bailey, Kent R.
;
Casaclang-Verzosa, Grace
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h-index: 0
机构:
Mayo Clin, Div Cardiovasc Dis, Rochester, MN 55905 USA
Mayo Clin, Div Internal Med, Rochester, MN USAMayo Clin, Div Cardiovasc Dis, Rochester, MN 55905 USA
Casaclang-Verzosa, Grace
;
Tsang, Teresa S. M.
论文数: 0引用数: 0
h-index: 0
机构:
Mayo Clin, Div Cardiovasc Dis, Rochester, MN 55905 USA
Mayo Clin, Div Internal Med, Rochester, MN USAMayo Clin, Div Cardiovasc Dis, Rochester, MN 55905 USA
机构:Mayo Clin & Mayo Fdn, Div Cardiovasc Dis & Internal Med, Mayo Echocardiog Res Ctr, Rochester, MN 55905 USA
Al-Omari, Malik A.
;
Finstuen, Joshua
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h-index: 0
机构:Mayo Clin & Mayo Fdn, Div Cardiovasc Dis & Internal Med, Mayo Echocardiog Res Ctr, Rochester, MN 55905 USA
Finstuen, Joshua
;
Appleton, Christopher P.
论文数: 0引用数: 0
h-index: 0
机构:Mayo Clin & Mayo Fdn, Div Cardiovasc Dis & Internal Med, Mayo Echocardiog Res Ctr, Rochester, MN 55905 USA
Appleton, Christopher P.
;
Barnes, Marion E.
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h-index: 0
机构:Mayo Clin & Mayo Fdn, Div Cardiovasc Dis & Internal Med, Mayo Echocardiog Res Ctr, Rochester, MN 55905 USA
Barnes, Marion E.
;
Tsang, Teresa S. M.
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h-index: 0
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Mayo Clin & Mayo Fdn, Div Cardiovasc Dis & Internal Med, Mayo Echocardiog Res Ctr, Rochester, MN 55905 USAMayo Clin & Mayo Fdn, Div Cardiovasc Dis & Internal Med, Mayo Echocardiog Res Ctr, Rochester, MN 55905 USA