Right heart dysfunction and failure in heart failure with preserved ejection fraction: mechanisms and management. Position statement on behalf of the Heart Failure Association of the European Society of Cardiology

European Journal of Heart Failure - Tập 20 Số 1 - Trang 16-37 - 2018
Thomas M. Gorter1, Dirk J. van Veldhuisen1, Johann Bauersachs2, Barry A. Borlaug3, Jelena Čelutkienė4, Andrew J.S. Coats5,6, María G. Crespo–Leiro7, Marco Guazzi8, Veli‐Pekka Harjola9, Stéphane Heymans10, Loreena Hill11, Mitja Lainščak12, Carolyn S.P. Lam13, Lars H. Lund14, Alexander R. Lyon15, Alexandre Mebazaa16, Christian Mueller17, Walter J. Paulus18, Burkert Pieske19, Massimo Piepoli20, Frank Ruschitzka21, Frans H. Rutten22, Petar Seferović23, Scott D. Solomon24, Sanjiv J. Shah25, Filippos Triposkiadis26, Rolf Wachter27, Carsten Tschöpe19, Rudolf A. de Boer1
1Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
2Department of Cardiology and Angiology, Medical School Hannover, Hannover, Germany
3Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Rochester, MN, USA
4Clinic of Cardiac and Vascular Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
5Monash University, Clayton Campus, Melbourne, Victoria 3800 Australia
6University of Warwick, Kirby Corner Road, Coventry CV4 8UW UK
7Advanced Heart Failure and Heart Transplant Unit, Servicio de Cardiologia‐CIBERCV Complejo Hospitalario Universitario A Coruña (CHUAC), Instituto Investigación Biomedica A Coruña (INIBIC), Universidad da Coruña (UDC), La Coruña, Spain
8Heart Failure Unit University of Milan, IRCCS Policlinico San Donato Milan Italy
9Emergency Medicine, University of Helsinki, Department of Emergency Medicine and Services Helsinki University Hospital Helsinki Finland
10Department of Cardiology, CARIM, Maastricht University Medical Centre, Maastricht, The Netherlands
11Queen's University, Belfast UK
12Department of Internal Medicine, General Hospital Murska Sobota, Murska Sobota, Slovenia
13Department of Cardiology, National Heart Center Singapore Singapore Duke-NUS Graduate Medical School Singapore
14Department of Medicine, Karolinska Institutet, and Heart and Vascular Theme, Karolinska University Hospital, Stockholm, Sweden
15National Heart and Lung Institute, Imperial College London and Royal Brompton Hospital, London, UK
16Department of Anesthesiology and Critical Care, APHP ‐ Saint Louis Lariboisière University Hospitals University Paris Diderot Paris France
17Department of Cardiology & Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland
18Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands
19Department of Internal Medicine and Cardiology, Charité University Medicine, Berlin, Germany, and Department of Internal Medicine Cardiology German Heart Center Berlin, DZHK (German Center for Cardiovascular Research) and Berlin Institute of Health (BIH) Berlin Germany
20Heart Failure Unit, Cardiac Department G. da Saliceto Hospital Piacenza Italy
21Clinic for Cardiology University Hospital Zurich Zürich Switzerland
22Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
23Cardiology Department, Clinical Centre Serbia, Medical School, Belgrade, Serbia
24Cardiovascular Division, Brigham and Women's Hospital, Boston, MA, USA
25Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
26Department of Cardiology, Larissa University Hospital, Larissa, Greece
27Clinic and Policlinic for Cardiology University Hospital Leipzig, Leipzig, Germany and German Cardiovascular Research Center partner site Göttingen

Tóm tắt

There is an unmet need for effective treatment strategies to reduce morbidity and mortality in patients with heart failure with preserved ejection fraction (HFpEF). Until recently, attention in patients with HFpEF was almost exclusively focused on the left side. However, it is now increasingly recognized that right heart dysfunction is common and contributes importantly to poor prognosis in HFpEF. More insights into the development of right heart dysfunction in HFpEF may aid to our knowledge about this complex disease and may eventually lead to better treatments to improve outcomes in these patients. In this position paper from the Heart Failure Association of the European Society of Cardiology, the Committee on Heart Failure with Preserved Ejection Fraction reviews the prevalence, diagnosis, and pathophysiology of right heart dysfunction and failure in patients with HFpEF. Finally, potential treatment strategies, important knowledge gaps and future directions regarding the right side in HFpEF are discussed.

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European Journal of Heart Failure

Tập 20 Số 1

16-37

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