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Tom 19 (2024): Continuous Publishing
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Opublikowany online: 2024-07-16

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Eksport do Mediów Społecznościowych

Eksport do Mediów Społecznościowych

Niewydolność serca z zachowaną i łagodnie obniżoną frakcją wyrzutową – od diagnozy do leczenia

Marcin Mikusek-Pham Van1, Anita Król1, Maciej Bulka1, Marcin Grabowski1, Agata Tymińska1
DOI: 10.5603/fc.99338

Streszczenie

Algorytmy diagnostyczne i postępowanie w przypadku niewydolności serca z obniżoną frakcją wyrzutową (HFrEF) są dobrze znane, sytuacja wygląda zupełnie inaczej w odniesieniu do dwóch pozostałych typów niewydolności serca (niewydolność serca z łagodnie obniżoną frakcją wyrzutową, HFmrEF oraz niewydolność serca z zachowaną frakcją wyrzutową, HFpEF). Najnowsze wytyczne europejskiego (European Society of Cardiology) oraz amerykańskich towarzystw (American College of Cardiology/American Heart Association/Heart Failure Society of America) mimo podobieństw, prezentują nieco odmienne strategie diagnostyki i leczenia HFmrEF oraz HFpEF. Celem tego artykułu jest przedstawienie aktualnej wiedzy na temat HFmrEF i HFpEF, ze szczególnym uwzględnieniem epidemiologii, diagnostyki i leczenia farmakologicznego, w tym porównanie wytycznych europejskich i amerykańskich.

Słowa kluczowe: niewydolność serca z zachowaną frakcją wyrzutowąniewydolność serca z łagodnie obniżoną frakcją wyrzutowądiagnostykafarmakoterapia

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Referencje

  1. Ponikowski P, Voors AA, Anker SD, et al. Authors/Task Force Members, Document Reviewers. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail. 2016; 18(8): 891–975.
    CrossRefPubMed
  2. McDonagh TA, Metra M, Adamo M, et al. ESC Scientific Document Group. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021; 42(36): 3599–3726.
    CrossRefPubMed
  3. Lam CSP, Solomon SD. The middle child in heart failure: heart failure with mid-range ejection fraction (40-50%). Eur J Heart Fail. 2014; 16(10): 1049–1055.
    CrossRefPubMed
  4. Anker SD, Butler J, Filippatos G, et al. EMPEROR-Preserved Trial Investigators. Empagliflozin in Heart Failure with a Preserved Ejection Fraction. N Engl J Med. 2021; 385(16): 1451–1461.
    CrossRefPubMed
  5. Solomon SD, McMurray JJV, Claggett B, et al. DELIVER Trial Committees and Investigators. Dapagliflozin in Heart Failure with Mildly Reduced or Preserved Ejection Fraction. N Engl J Med. 2022; 387(12): 1089–1098.
    CrossRefPubMed
  6. Solomon SD, McMurray JJV, Anand IS, et al. PARAGON-HF Investigators and Committees. Angiotensin-Neprilysin Inhibition in Heart Failure with Preserved Ejection Fraction. N Engl J Med. 2019; 381(17): 1609–1620.
    CrossRefPubMed
  7. Yancy CW, Jessup M, Bozkurt B, et al. WRITING COMMITTEE MEMBERS, 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. Circulation. 2013; 128(16): e240–e327.
    CrossRefPubMed
  8. Chioncel O, Lainscak M, Seferovic PM, et al. Epidemiology and one-year outcomes in patients with chronic heart failure and preserved, mid-range and reduced ejection fraction: an analysis of the ESC Heart Failure Long-Term Registry. Eur J Heart Fail. 2017; 19(12): 1574–1585.
    CrossRefPubMed
  9. Sicras-Mainar A, Sicras-Navarro A, Palacios B, et al. Epidemiology and treatment of heart failure in Spain: the HF-PATHWAYS study. Rev Esp Cardiol (Engl Ed). 2022; 75(1): 31–38.
    CrossRefPubMed
  10. Guisado-Espartero ME, Salamanca-Bautista P, Aramburu-Bodas Ó, et al. RICA investigators group. Heart failure with mid-range ejection fraction in patients admitted to internal medicine departments: Findings from the RICA Registry. Int J Cardiol. 2018; 255: 124–128.
    CrossRefPubMed
  11. Eaton CB, Pettinger M, Rossouw J, et al. Risk Factors for Incident Hospitalized Heart Failure With Preserved Versus Reduced Ejection Fraction in a Multiracial Cohort of Postmenopausal Women. Circ Heart Fail. 2016; 9(10).
    CrossRefPubMed
  12. 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): 701–709.
    CrossRefPubMed
  13. Kapłon-Cieślicka A, Lund LH. Atrial fibrillation in heart failure with preserved ejection fraction: a risk marker, risk factor or confounder? Heart. 2020; 106(24): 1949.
    CrossRefPubMed
  14. Kapłon-Cieślicka A, Benson L, Chioncel O, et al. on behalf of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC) and the ESC Heart Failure Long-Term Registry Investigators. A comprehensive characterization of acute heart failure with preserved versus mildly reduced versus reduced ejection fraction - insights from the ESC-HFA EORP Heart Failure Long-Term Registry. Eur J Heart Fail. 2022; 24(2): 335–350.
    CrossRefPubMed
  15. Shah SJ, Lam CSP, Svedlund S, et al. Prevalence and correlates of coronary microvascular dysfunction in heart failure with preserved ejection fraction: PROMIS-HFpEF. Eur Heart J. 2018; 39(37): 3439–3450.
    CrossRefPubMed
  16. Savarese G, Vedin O, D'Amario D, et al. Prevalence and Prognostic Implications of Longitudinal Ejection Fraction Change in Heart Failure. JACC Heart Fail. 2019; 7(4): 306–317.
    CrossRefPubMed
  17. Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022; 145(18): e895–e1032.
    CrossRefPubMed
  18. Bozkurt B, Coats AJs, Tsutsui H, et al. Universal definition and classification of heart failure. J Card Fail. 2021 [Epub ahead of print].
    CrossRefPubMed
  19. Zawadzka MM, Grabowski M, Kapłon-Cieślicka A. Phenotyping in heart failure with preserved ejection fraction: a key to find effective treatment. Adv Clin Exp Med. 2022; 31(10): 1163–1172.
    CrossRefPubMed
  20. 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 J Heart Fail. 2020; 22(3): 391–412.
    CrossRefPubMed
  21. Reddy YNV, Carter RE, Obokata M, et al. A simple, evidence-based approach to help guide diagnosis of heart failure with preserved ejection fraction. Circulation. 2018; 138(9): 861–870.
    CrossRefPubMed
  22. Segar MW, Patel KV, Berry JD, et al. Generalizability and Implications of the HFPEF Score in a Cohort of Patients With Heart Failure With Preserved Ejection Fraction. Circulation. 2019; 139(15): 1851–1853.
    CrossRefPubMed
  23. Myhre PL, Vaduganathan M, Claggett BL, et al. Application of the H FPEF score to a global clinical trial of patients with heart failure with preserved ejection fraction: the TOPCAT trial. Eur J Heart Fail. 2019; 21(10): 1288–1291.
    CrossRefPubMed
  24. Sanders-van Wijk S, Barandiarán Aizpurua A, Brunner-La Rocca HP, et al. The HFA-PEFF and H FPEF scores largely disagree in classifying patients with suspected heart failure with preserved ejection fraction. Eur J Heart Fail. 2021; 23(5): 838–840.
    CrossRefPubMed
  25. Selvaraj S, Myhre PL, Vaduganathan M, et al. Application of diagnostic algorithms for Heart Failure with preserved ejection fraction to the community. JACC Heart Fail. 2020; 8(8): 640–653.
    CrossRefPubMed
  26. Ouwerkerk W, Tromp J, Jin X, et al. Heart failure with preserved ejection fraction diagnostic scores in an Asian population. Eur J Heart Fail. 2020; 22(9): 1737–1739.
    CrossRefPubMed
  27. Formiga F, Nuñez J, Castillo Moraga MJ, et al. Diagnosis of heart failure with preserved ejection fraction: a systematic narrative review of the evidence. Heart Fail Rev. 2024; 29(1): 179–189.
    CrossRefPubMed
  28. Nagueh SF, Smiseth OA, Appleton CP, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the american society of echocardiography and the european association of Cardiovascular imaging. J Am Soc Echocardiogr. 2016; 29(4): 277–314.
    CrossRefPubMed
  29. 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): 3297–3317.
    CrossRefPubMed
  30. Edelmann F, Wachter R, Schmidt AG, et al. Aldo-DHF Investigators. Effect of spironolactone on diastolic function and exercise capacity in patients with heart failure with preserved ejection fraction: the Aldo-DHF randomized controlled trial. JAMA. 2013; 309(8): 781–791.
    CrossRefPubMed
  31. Pitt B, Pfeffer MA, Assmann SF, et al. TOPCAT Investigators. Spironolactone for heart failure with preserved ejection fraction. N Engl J Med. 2014; 370(15): 1383–1392.
    CrossRefPubMed
  32. Pfeffer MA, Claggett B, Assmann SF, et al. 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.
    CrossRefPubMed
  33. McDonagh TA, Metra M, Adamo M, et al. ESC Scientific Document Group. 2023 Focused Update of the 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2023; 44(37): 3627–3639.
    CrossRefPubMed
  34. Butt JH, Jhund PS, Belohlávek J, et al. Efficacy and safety of dapagliflozin according to frailty in patients with heart failure: a prespecified analysis of the DELIVER trial. Circulation. 2022; 146(16): 1210–1224.
    CrossRefPubMed
  35. Butt JH, Jhund PS, Belohlávek J, et al. Efficacy and safety of dapagliflozin according to frailty in patients with heart failure: a prespecified analysis of the DELIVER trial. Circulation. 2022; 146(16): 1210–1224.
    CrossRefPubMed
  36. Peikert A, Martinez FA, Vaduganathan M, et al. Efficacy and safety of dapagliflozin in heart failure with mildly reduced or preserved ejection fraction according to age: the DELIVER trial. Circ Heart Fail. 2022; 15(10): e010080.
    CrossRefPubMed
  37. Butt JH, Kondo TP, Jhund PS, et al. Atrial fibrillation and dapagliflozin efficacy in patients with preserved or mildly reduced ejection fraction. J Am Coll Cardiol. 2022; 80(18): 1705–1717.
    CrossRefPubMed
  38. Myhre PL, Vaduganathan M, Claggett BL, et al. Influence of nt-probnp on efficacy of dapagliflozin in heart failure with mildly reduced or preserved ejection fraction. JACC Heart Fail. 2022; 10(12): 902–913.
    CrossRefPubMed
  39. Nassif ME, Windsor SL, Borlaug BA, et al. The SGLT2 inhibitor dapagliflozin in heart failure with preserved ejection fraction: a multicenter randomized trial. Nat Med. 2021; 27(11): 1954–1960.
    CrossRefPubMed
  40. Cleland JGF, Tendera M, Adamus J, et al. PEP-CHF Investigators. The perindopril in elderly people with chronic heart failure (PEP-CHF) study. Eur Heart J. 2006; 27(19): 2338–2345.
    CrossRefPubMed
  41. Yip GWK, Wang M, Wang T, et al. The Hong Kong diastolic heart failure study: a randomised controlled trial of diuretics, irbesartan and ramipril on quality of life, exercise capacity, left ventricular global and regional function in heart failure with a normal ejection fraction. Heart. 2008; 94(5): 573–580.
    CrossRefPubMed
  42. Lund LH, Claggett B, Liu J, et al. Heart failure with mid-range ejection fraction in CHARM: characteristics, outcomes and effect of candesartan across the entire ejection fraction spectrum. Eur J Heart Fail. 2018; 20(8): 1230–1239.
    CrossRefPubMed
  43. Solomon SD, Vaduganathan M, L Claggett B, et al. Sacubitril/Valsartan across the spectrum of ejection fraction in heart failure. Circulation. 2020; 141(5): 352–361.
    CrossRefPubMed
  44. Tsuji K, Sakata Y, Nochioka K, et al. Characterization of heart failure patients with mid‐range left ventricular ejection fraction—a report from the CHART‐2 Study. European Journal of Heart Failure. 2017; 19(10): 1258–1269.
    CrossRefPubMed
  45. Montenegro Sá F, Carvalho R, Ruivo C, et al. Portuguese Registry of Acute Coronary Syndrome Investigators. Beta-blockers for post-acute coronary syndrome mid-range ejection fraction: a nationwide retrospective study. Eur Heart J Acute Cardiovasc Care. 2019; 8(7): 599–605.
    CrossRefPubMed
  46. Cleland JGF, Bunting KV, Flather MD, et al. Beta-blockers in Heart Failure Collaborative Group. Beta-blockers for heart failure with reduced, mid-range, and preserved ejection fraction: an individual patient-level analysis of double-blind randomized trials. Eur Heart J. 2018; 39(1): 26–35.
    CrossRefPubMed
  47. Fukuta H, Goto T, Wakami K, et al. Effect of beta-blockers on heart failure severity in patients with heart failure with preserved ejection fraction: a meta-analysis of randomized controlled trials. Heart Fail Rev. 2021; 26(1): 165–171.
    CrossRefPubMed
  48. Avula HR, Leong TK, Lee KK, et al. Long-Term outcomes of adults with heart failure by left ventricular systolic function status. Am J Cardiol. 2018; 122(6): 1008–1016.
    CrossRefPubMed
  49. Ilieșiu AM, Hodorogea AS. Treatment of heart failure with preserved ejection fraction. Adv Exp Med Biol. 2018; 1067: 67–87.
    CrossRefPubMed
  50. Armstrong PW, Lam CSP, Anstrom KJ, et al. VITALITY-HFpEF Study Group. Effect of vericiguat vs placebo on quality of life in patients with heart failure and preserved ejection fraction: the vitality-hfpef randomized clinical trial. JAMA. 2020; 324(15): 1512–1521.
    CrossRefPubMed
  51. 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): 1119–1127.
    CrossRefPubMed
  52. Maurer MS, Schwartz JH, Gundapaneni B, et al. ATTR-ACT Study Investigators. Tafamidis treatment for patients with transthyretin amyloid cardiomyopathy. N Engl J Med. 2018; 379(11): 1007–1016.
    CrossRefPubMed
  53. Ommen SR, Mital S, Burke MA, et al. 2020 AHA/ACC guideline for the diagnosis and treatment of patients with hypertrophic cardiomyopathy: a report of the american college of cardiology/american heart association joint committee on clinical practice guidelines. Circulation. 2020; 142(25): e558–e631.
    CrossRefPubMed
  54. Arbelo E, Protonotarios A, Gimeno JR, et al. ESC Scientific Document Group. 2023 ESC Guidelines for the management of cardiomyopathies. Eur Heart J. 2023; 44(37): 3503–3626.
    CrossRefPubMed
  55. Olivotto I, Oreziak A, Barriales-Villa R, et al. EXPLORER-HCM study investigators. Mavacamten for treatment of symptomatic obstructive hypertrophic cardiomyopathy (EXPLORER-HCM): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2020; 396(10253): 759–769.
    CrossRefPubMed
  56. Desai MY, Owens A, Geske JB, et al. Myosin inhibition in patients with obstructive hypertrophic cardiomyopathy referred for septal reduction therapy. J Am Coll Cardiol. 2022; 80(2): 95–108.
    CrossRefPubMed
  57. Bishev D, Fabara S, Loseke I, et al. Efficacy and safety of mavacamten in the treatment of hypertrophic cardiomyopathy: a systematic review. Heart Lung Circ. 2023; 32(9): 1049–1056.
    CrossRefPubMed
  58. Maron MS, Masri A, Choudhury L, et al. REDWOOD-HCM Steering Committee and Investigators. Phase 2 study of aficamten in patients with obstructive hypertrophic cardiomyopathy. J Am Coll Cardiol. 2023; 81(1): 34–45.
    CrossRefPubMed
  59. Ho CY, Mealiffe ME, Bach RG, et al. Evaluation of mavacamten in symptomatic patients with nonobstructive hypertrophic cardiomyopathy. J Am Coll Cardiol. 2020; 75(21): 2649–2660.
    CrossRefPubMed
  60. A randomized, double-blind, placebo-controlled clinical study to evaluate mavacamten in adults with symptomatic non-obstructive hypertrophic cardiomyopathy clinicaltrials. gov Identifier. : NCT05582395.
  61. A phase 3, multi-center, randomized, double-blind trial to evaluate the efficacy and safety of aficamten compared to placebo in adults with symptomatic non-obstructive hypertrophic cardiomyopathy clinicaltrials. gov Identifier. : NCT06081894.
  62. Ather S, Chan W, Bozkurt B, et al. Impact of noncardiac comorbidities on morbidity and mortality in a predominantly male population with heart failure and preserved versus reduced ejection fraction. J Am Coll Cardiol. 2012; 59(11): 998–1005.
    CrossRefPubMed
  63. Kao DP, Lewsey JD, Anand IS, et al. Characterization of subgroups of heart failure patients with preserved ejection fraction with possible implications for prognosis and treatment response. Eur J Heart Fail. 2015; 17(9): 925–935.
    CrossRefPubMed
  64. 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.
    CrossRefPubMed
  65. Karavidas A, Farmakis D. Alternative modes of exercise training in heart failure with preserved ejection fraction: is it time to give them serious consideration? Rev Esp Cardiol (Engl Ed). 2019; 72(4): 279–281.
    CrossRefPubMed
  66. Haass M, Kitzman DW, Anand IS, et al. Body mass index and adverse cardiovascular outcomes in heart failure patients with preserved ejection fraction: results from the Irbesartan in Heart Failure with Preserved Ejection Fraction (I-PRESERVE) trial. Circ Heart Fail. 2011; 4(3): 324–331.
    CrossRefPubMed
  67. Kosiborod MN, Abildstrøm SZ, Borlaug BA, et al. STEP-HFpEF Trial Committees and Investigators. Semaglutide in patients with heart failure with preserved ejection fraction and obesity. N Engl J Med. 2023; 389(12): 1069–1084.
    CrossRefPubMed
  68. Gevaert AB, Tibebu S, Mamas MA, et al. Clinical phenogroups are more effective than left ventricular ejection fraction categories in stratifying heart failure outcomes. ESC Heart Fail. 2021; 8(4): 2741–2754.
    CrossRefPubMed
  69. Lam CSP, Solomon SD. Fussing over the middle child: heart failure with mid-range ejection fraction. Circulation. 2017; 135(14): 1279–1280.
    CrossRefPubMed

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