Insuficiencia cardíaca con fracción de eyección ventricular preservada

  1. Amores Luque, M.C. 1
  2. Sánchez Vega, J.D. 1
  3. Alonso Salinas, G.L. 1
  4. Zamorano Gómez, J.L. 1
  1. 1 Servicio de Cardiología, Hospital Universitario Ramón y Cajal, Madrid, España
Revista:
Medicine: Programa de Formación Médica Continuada Acreditado

ISSN: 0304-5412

Año de publicación: 2021

Título del ejemplar: Enfermedades cardiovasculares (I)

Serie: 13

Número: 35

Páginas: 2037-2044

Tipo: Artículo

DOI: 10.1016/J.MED.2021.06.004 DIALNET GOOGLE SCHOLAR

Otras publicaciones en: Medicine: Programa de Formación Médica Continuada Acreditado

Objetivos de desarrollo sostenible

Resumen

Heart failure (HF) with preserved left ventricular ejection fraction (PLVEF) is a major cause of morbidity and mortality in our setting, and its prevalence is rising due to the ageing population and increased comorbidities that impact the cardiovascular system. Mortality rates are close to those of patients with reduced ejection fraction (rLVEF). Diastolic dysfunction due to increased myocardial stiffness is the basis of this condition, as there is retrograde transmission of filling pressures to the pulmonary vascular circuit and right chambers. An increased proinflammatory and prothrombotic state has been described as the origin of the problem at the molecular level. Diagnosis is very challenging, and there is no single validated method, several score tables have been proposed based on clinical, laboratory, echocardiographic findings, and invasive measurement of the left ventricle diastolic pressure. No drug has been shown to improve survival or decrease the rate of admissions due to HF. Treatment focusses on improving functional capacity and quality of life, with emphasis on the management of comorbidities and blood volume status.

Referencias bibliográficas

  • Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JGF, Coats AJS. 2016 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure. Rev Esp Cardiol (Engl Ed). 2016;69(12):1167.
  • van Riet EE, Hoes AW, Wagenaar KP, Limburg A, Landman MA, Rutten FH. Epidemiology of heart failure: the prevalence of heart failure and ventricular dysfunction in older adults over time. A systematic review. Eur J Heart Fail. 2016;18:242-52.
  • Oktay AA, Rich JD, Shah SJ. The emerging epidemic of heart failure with preserved ejection fraction. Curr Heart Fail Rep. 2013;10:401-10.
  • Pieske B, Tschöpe C, de Boer RA, Fraser AG, Anker SD, Donal E. 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):3297-17.
  • Carson PE, Anand IS, Win S, Rector T, Haass M, Lopez Sendon J. The hospitalization burden and post-hospitalization mortality risk in heart failure with preserved ejection fraction: results from the I-PRE-SERVE Trial (irbesartan in heart failure and preserved ejection fraction). JACC Heart Fail. 2015;3(6):429-4416.
  • McMurray JJ, Carson PE, Komajda M, McKelvie R, Zile MR, Ptaszynska A. Heart failure with preserved ejection fraction: clinical characteristics of 4133 patients enrolled in the I-PRESERVE trial. Eur J Heart Fail. 2008;10(2):149-56.
  • Borlaug BA, Lam CS, Roger VL, Rodeheffer RJ, Redfield MM. Contractility and ventricular systolic stiffening in hypertensive heart disease: insights into the pathogenesis of heart failure with preserved ejection fraction. J Am Coll Cardiol. 2009;54:410-8.
  • Zile MR. Insuficiencia cardíaca con fracción de eyección conservada. En: Zipes DP, ed. Braunwald. Tratado de Cardiología. 11ª ed. Barcelona: Elsevier; 2019. p. 523-42.
  • Paulus WJ, Tschöpe C. A novel paradigm for heart failure with preserved ejection fraction: comorbidities drive myocardial dysfunction and remodeling through coronary microvascular endothelial inflammation. J Am Coll Cardiol. 2013;62(4):263-71.
  • Tan YT, Wenzelburger F, Lee E, Heatlie G, Leyva F, Patel K. The pathophysiology of heart failure with normal ejection fraction: exercise echocardiography reveals complex abnormalities of both systolic and diastolic ventricular function involving torsion, untwist, and longitudinal motion. J Am Coll Cardiol. 2009;54(1):36-46.
  • Borlaug BA, Olson TP, Lam CS, Flood KS, Lerman A, Johnson BD. Global cardiovascular reserve dysfunction in heart failure with preserved ejection fraction. J Am Coll Cardiol. 2010;56(11):845-54.
  • Lam CS, Roger VL, Rodeheffer RJ, Borlaug BA, Enders FT, Redfield MM. Pulmonary hypertension in heart failure with preserved ejection fraction: a community based study. J Am Coll Cardiol. 2009;53:1119-26.
  • Gorter TM, Obokata M, Reddy YN, Melenovsky V, Borlaug BA. Exercise unmasks distinct pathophysiologic features in heart failure with preserved ejection fraction and pulmonary vascular disease. Eur Heart J. 2018;39:2825-35.
  • Melenovsky V, Hwang SJ, Lin G, Redfield MM, Borlaug BA. Right heart dysfunction in heart failure with preserved ejection fraction. Eur Heart J. 2014;35:3452-62.
  • Guazzi M, Bandera F, Pelissero G, Castelvecchio S, Menicanti L, Ghio S. Tricuspid annular plane systolic excursion and pulmonary arterial systolic pressure relationship in heart failure: an index of right ventricular contractile function and prognosis. Am J Physiol Heart Circ Physiol. 2013;305(9):H1373-81.
  • Obokata M, Reddy YN, Melenovsky V, Pislaru SV, Borlaug BA. Deterioration in right ventricular structure and function over time in heart failure with preserved ejection fraction. Eur Heart J. 2019;40:689-97.
  • Borlaug BA. The pathophysiology of heart failure with preserved ejection fraction. Nat Rev Cardiol. 2014;11:507-15.
  • Melenovsky V, Hwang SJ, Redfield MM, Zakeri R, Lin G, Borlaug BA. Left atrial remodeling and function in advanced heart failure with preserved or reduced ejection fraction. Circ Heart Fail. 2015;8:295-303.
  • Obokata M, Reddy YNV, Melenovsky V, Kane GC, Olson TP, Jarolim P. Myocardial injury and cardiac reserve in patients with heart failure and preserved ejection fraction. J Am Coll Cardiol. 2018;72:29-40.
  • Mohammed SF, Borlaug BA, Roger VL, Mirzoyev SA, Rodeheffer RJ, Chirinos JA. Comorbidity and ventricular and vascular structure and function in heart failure with preserved ejection fraction: a community based study. Circ Heart Fail. 2012;5:710-9.
  • Komajda M, Carson PE, Hetzel S, McKelvie R, McMurray J, Ptaszynska A. Factors associated with outcome in heart failure with preserved ejection fraction: findings from the Irbesartan in Heart Failure with Preserved Ejection Fraction Study (I-Preserve). Circ Heart Fail. 2011;4:27-35.
  • Lam CSP, Carson PE, Anand IS, Rector TS, Kuskowski M, Komajda M. Sex differences in clinical characteristics and outcomes in elderly patients with heart failure and preserved ejection fraction: the Irbesartan in Heart Failure with Preserved Ejection Fraction (I-Preserve) Trial. Circ Heart Fail. 2012;5:571-8.
  • Little WC, Lam C, Little WC. Sex and cardiovascular risk: Are women advantaged or men disadvantaged? Circulation. 2012;126:913.
  • Obokata M, Reddy YN, Pislaru SV, Melenovsky V, Borlaug BA. Evidence supporting the existence of a distinct obese phenotype of heart failure with preserved ejection fraction. Circulation. 2017;136:6-19.
  • Smith GL, Lichtman JH, Bracken MB, Shlipak MG, Phillips CO, DiCapua P. Renal impairment and outcomes in heart failure: systematic review and meta analysis. J Am Coll Cardiol. 2006;47:1987-96.
  • Reddy YNV, Carter RE, Obokata M, Redfield MM, Borlaug BA. A simple, evidence based approach to help guide diagnosis of heart failure with preserved ejection fraction. Circulation. 2018; 138(9):861-70.
  • Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE Jr, Drazner MH. American College of Cardiology Foundation; American Heart Association Task Force on Practice Guidelines. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013;62(16):e147-239.
  • Ho JE, Zern EK, Wooster L, Bailey CS, Cunningham T, Eisman AS. differential clinical profiles, exercise responses, and outcomes associated with existing HFpEF definitions. Circulation. 2019;140(5):353-65.
  • Wright Jr JT, Williamson JD, Whelton PK. SPRINT Research Group. A randomized trial of intensive versus standard blood pressure control. N Engl J Med. 2015;373:2103-16.
  • Pitt B, Pfeffer MA, Assmann SF, Boineau R, Anand IS, Claggett B. Spironolactone for heart failure with preserved ejection fraction. N Engl J Med. 2014;370(15):1383-92.
  • Pfeffer MA, Claggett B, Assmann SF, Boineau R, Anand IS, Clausell N. Regional variation in patients and outcomes in the treatment of preserved cardiac function heart failure with an aldosterone antagonist (TOPCAT) Trial. Circulation. 2015;131(1):34-42.
  • Merrill M, Sweitzer NK, Lindenfeld J, Kao DP. Sex differences in outcomes and responses to spironolactone in heart failure with preserved ejection fraction. JACC: Heart Failure. 2019;7(3):228-38.
  • Solomon SD, Claggett B, Lewis EF, Desai A, Anand I, Sweitzer NK. Influence of ejection fraction on outcomes and efficacy of spironolactone in patients with heart failure with preserved ejection fraction. Eur Heart J. 2016;37(5):455-62.
  • Solomon SD, McMurray JJV, Anand IS, Ge J, Lam CSP, Maggioni AP. Angiotensin neprilysin inhibition in heart failure with preserved ejection fraction. N Engl J Med. 2019;381(17):1609-20.
  • McMurray JJV, Jackson AM, Lam CSP, Redfield MM, Anand IS, Ge J. Effects of sacubitril-valsartan versus valsartan in women compared with men with heart failure and preserved ejection fraction: insights from PARAGON-HF. Circulation. 2020;141(5):338-51.
  • Adamson PB, Abraham WT, Aaron M, Aranda JM Jr, Bourge RC, Smith A. Champion trial rationale and design: the long-term safety and clinical efficacy of a wireless pulmonary artery pressure monitoring system. J Card Fail. 2011;17(1):3-10.
  • Kaye DM, Petrie MC, McKenzie S, Hasenfu` G, Malek F, Post Met al; REDUCE LAP-HF study investigators. Impact of an interatrial shunt device on survival and heart failure hospitalization in patients with preserved ejection fraction. ESC Heart Fail. 2019 Feb;6(1):62-9.
  • Boren SA, Wakefield BJ, Gunlock TL, Wakefield DS. Heart failure self-management education: a systematic review of the evidence. Int J Evid Based Healthc. 2009 Sep;7(3):159-68.
  • Bradley TD, Logan AG, Kimoff RJ. Continuous positive airway pressure for central sleep apnea and heart failure. N Engl J Med. 2005;353:2025-33.
  • Redfield MM. Heart failure with preserved ejection fraction. N Engl J Med. 2016;375(19):1868-77.
Fuente de los datos: Dialnet