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Heart failure with preserved ejection fraction

Journal of Geriatric Cardiology 2013年第4期10卷 369-376页

作者： Marzia Rigollil gillian a whalley Awhina Health Campus Waitakere Hospital Waitemata District Health Board Private Bag93-503 Auckland New Zealand Division of Cardiology University of Verona Ospedale Maggiore Pie Stefani 1 37126 Verona Italy Faculty of Social and Health Sciences Unitec Institute of Technology Private Bag92025 Auckland NewZealand

Progressive aging of the population and prolonga tion of life expect ancy have led to the ris ng prevalence of heart failure (HF)。Despitethe improvements in medical therapy，the mortality rate of this condition has remained unaccept ably high，becoming t heprimary cause ofdeath in the elderly popul at ion。Almost half of patient swith signs and symptoms of HF are f ound to have a nearly normal ejection fraction，which delineates a distinctclinical syndrome 。known as HF with preserved ejection fraction(HF-PEF) 。While early research focused on the importance of diastolicdys function，more recent studies reported the pathophysological compl exity of the disease with multiple cardiovas 。cular abnormalities contributing to its development and progression。HF-PEF is a challenging maj or health problem with yet no solution as there is no evidence。Based treatment which improves clinical out comes。This review summarizes the state of current knowledge on diagnosis，prognosis and treatment of HF。PEF，with particul ar insights on the pathological characteristics in the elderly population。

关键词： Diastole Echocardiography Heart failure Mortality Preserved ejection fraction

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Assessment and impact of diastolic function by echocardiography in elderly patients

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Journal of Geriatric Cardiology 2016年第3期13卷 252-260页

作者： Clementina Dugo Marzia Rigolli Andrea Rossi gillian a whalley Awhina Health Campus Waitemata District Health Board Auckland New Zealand Section of Cardiology Department of Medicine University of Verona Italy Institute of Diagnostic Ultrasound Australasian Sonographers Association Melbourne Australia

Doppler echocardiography is the gold standard for assessment of diastolic dysfunction, which is increasingly recognised as a cause of heart failure, especially in the elderly. Using a combination of Doppler echocardiography techniques, it is possible to identify grades of dia- stolic dysftmction, estimate left ventricular filling pressures and establish the chronicity of diastolic dysfunction. These physiologi- cally-derived measures have been widely validated against invasive measurements of left heart pressures and have been shown to be prog- nostically valuable in a wide range of clinical settings. This review explores the mechanisms, and approaches to the assessment of diastolic dysfunction in the elderly. The challenge for clinicians is to identify pathophysiological changes from those associated with normal ageing. When used in combination, and taking age into account, Doppler echocardiographic parameters are helpful in the assessment of dyspnoea in older patients and provide prognostic insights.

关键词： Diastolic dysfunction Doppler Echocardiography

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