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锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷衰锟斤拷锟斤拷锟斤拷锟叫撅拷锟斤拷锟街ｏ拷锟斤拷锟斤拷锟斤拷衰锟斤拷锟斤拷锟斤拷锟杰憋拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟窖拷锟斤拷锟�(LVEF)锟斤拷锟斤拷锟斤拷锟狡达拷锟斤拷锟斤拷衰为锟斤拷锟斤拷锟斤拷锟斤拷锟叫达拷锟斤拷锟斤拷锟斤拷锟斤拷锟剿ワ拷锟�2007锟疥， 欧锟斤拷锟斤拷锟斤拷学锟斤拷(ESC)锟斤拷衰锟斤拷锟斤拷锟洁超锟斤拷锟介将锟斤拷锟斤拷锟斤拷衰锟侥筹拷为锟斤拷锟斤拷锟斤拷血锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷衰锟斤拷(HFNEF)锟斤拷锟斤拷锟节★拷欧锟斤拷锟斤拷锟斤拷锟斤拷志锟斤拷锟斤拷Eur Heart J 2007锟斤拷28(20)锟斤拷2539锟斤拷锟较凤拷锟斤拷锟斤拷锟叫关该硷拷锟斤拷锟斤拷系锟阶拷夜锟绞讹拷锟侥壳帮拷锟斤拷蟛糠锟揭绞︼拷锟紿FNEF锟斤拷锟斤拷知远锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟杰诧拷全锟斤拷(锟斤拷血锟斤拷锟斤拷锟斤拷锟斤拷)锟斤拷衰锟斤拷锟斤拷知锟斤拷锟诫。锟斤拷HFNEF锟侥凤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟狡癸拷锟斤拷锟斤拷锟皆达拷锟斤拷锟斤拷锟斤拷锟斤拷锟轿达拷锟斤拷锟斤拷锟斤拷猓拷写锟教斤拷锟斤拷锟�
1. HFNEF锟斤拷锟斤拷
HFNEF锟斤拷指锟斤拷锟斤拷锟斤拷锟斤拷衰(DHF)锟斤拷锟斤拷锟斤拷锟斤拷锟缴弛伙拷锟斤拷锟斤拷锟斤拷锟揭斤拷硬锟斤拷锟斤拷锟斤拷锟脚癸拷锟杰诧拷全锟斤拷锟斤拷然锟斤拷锟斤拷HFNEF锟斤拷锟斤拷全锟斤拷同锟斤拷DHF锟斤拷锟斤拷同锟斤拷锟缴硷拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷衰(SHF)锟斤拷HFNEF锟斤拷锟斤拷锟斤拷然锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟杰ｏ拷锟斤拷锟皆达拷锟斤拷锟侥硷拷锟斤拷织锟斤拷锟斤拷锟斤拷锟劫度斤拷锟酵ｏ拷锟斤拷锟街斤拷锟酵憋拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷一锟斤拷锟教讹拷锟斤拷锟斤拷锟斤拷缺锟斤拷锟斤拷确锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟杰诧拷全锟斤拷锟斤拷锟斤拷拢锟斤拷锟斤拷诓锟斤拷锟絃VEF锟斤拷锟酵碉拷锟斤拷衰锟斤拷锟斤拷锟斤拷锟斤拷锟劫达拷锟斤拷霞锟斤拷俅锟斤拷芯锟斤拷芯锟斤拷锟街狧FNEF锟斤拷锟斤拷锟斤拷锟斤拷血锟斤拷锟斤拷锟叫达拷锟斤拷锟剿ワ拷锟斤拷锟斤拷锟斤拷锟轿狣HF锟斤拷
2. HFNEF锟斤拷希锟阶拷夜锟绞�
锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷衰锟斤拷锟竭碉拷LVEF≥50%锟斤拷锟斤拷锟斤拷为HFNEF锟斤拷锟揭讹拷为锟斤拷锟疥、女锟皆和革拷血压锟斤拷锟竭★拷HFNEF锟斤拷SHF锟斤拷锟狡ｏ拷锟斤拷锟斤拷锟绞猴拷锟斤拷锟斤拷锟斤拷锟洁当锟斤拷(1锟斤拷锟斤拷锟斤拷锟斤拷>20%)锟斤拷锟揭伙拷锟斤拷锟斤拷锟节诧拷锟斤拷锟斤拷锟斤拷锟斤拷
HFNEF锟斤拷锟斤拷辖锟轿拷锟斤拷樱锟�2007锟斤拷ESC专锟揭癸拷识锟斤拷锟斤拷锟剿该硷拷锟斤拷锟斤拷锟斤拷媳锟阶�(图1)锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷3锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷衰锟斤拷症状锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷为锟斤拷锟斤拷锟斤拷锟斤拷也锟斤拷锟斤拷为HFNEF锟斤拷锟劫达拷证锟捷★拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷斐ｏ拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷埽锟絃VEF>50%锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷末锟捷伙拷指锟斤拷(LVEDVI)<97 ml/m2锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟脚癸拷锟杰诧拷全锟斤拷证锟捷ｏ拷锟斤拷锟斤拷锟叫达拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟脚癸拷锟杰诧拷全锟斤拷指锟疥，锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷末压(LVEDP)锟斤拷平锟斤拷锟斤拷毛细血锟斤拷楔压(mPCW)锟饺★拷锟斤拷锟斤拷锟斤拷一系锟斤拷锟睫达拷锟斤拷锟斤拷指锟疥及锟斤拷锟斤拷锟斤拷
3. HFNEF锟斤拷锟狡ｏ拷指锟斤拷锟狡硷拷
HFNEF锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷确锟斤拷锟窖ひ窖еわ拷荨锟�2005锟斤拷锟斤拷锟斤拷锟斤拷锟洁病学锟斤拷/锟斤拷锟斤拷锟斤拷锟斤拷学锟斤拷(ACC/AHA)锟戒布锟侥★拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷衰锟斤拷锟斤拷锟斤拷指锟较★拷锟斤拷锟斤拷LVEF锟斤拷锟斤拷锟斤拷锟斤拷衰锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟狡硷拷锟斤拷
锟斤拷锟斤拷锟斤拷锟狡硷拷
锟斤拷锟斤拷医师锟斤拷锟斤拷锟斤拷锟斤拷指锟斤拷锟斤拷锟斤拷锟狡伙拷锟竭碉拷锟斤拷锟斤拷锟节猴拷锟斤拷锟斤拷锟节革拷血压(A锟斤拷);锟斤拷锟节合诧拷锟斤拷锟斤拷锟侥伙拷锟竭ｏ拷锟斤拷锟斤拷锟斤拷锟皆匡拷锟斤拷锟斤拷锟斤拷锟斤拷(C锟斤拷);锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟皆匡拷锟狡凤拷锟斤拷血锟斤拷锟斤拷锟斤拷水锟斤拷(C锟斤拷)锟斤拷
锟斤拷锟斤拷a锟斤拷锟狡硷拷
锟斤拷锟节合诧拷锟斤拷锟侥诧拷锟斤拷HFNEF锟斤拷锟竭ｏ拷锟斤拷锟斤拷症状锟斤拷证实锟斤拷锟斤拷锟侥硷拷缺血锟斤拷锟侥癸拷锟斤拷锟叫革拷锟斤拷影锟届，锟斤拷锟叫癸拷锟斤拷血锟斤拷锟截斤拷锟斤拷锟角猴拷锟斤拷锟斤拷(C锟斤拷)锟斤拷
锟斤拷锟斤拷b锟斤拷锟狡硷拷
锟斤拷锟节合诧拷锟斤拷锟斤拷锟斤拷HFNEF锟斤拷锟竭ｏ拷锟街革拷锟斤拷维锟斤拷锟斤拷越锟斤拷煽锟斤拷锟斤拷锟斤拷锟斤拷诟锟斤拷锟街⒆�(C锟斤拷);应锟斤拷β锟斤拷锟斤拷锟斤拷锟酵硷拷锟斤拷血锟杰斤拷锟斤拷锟斤拷转锟斤拷酶锟斤拷锟狡硷拷(ACEI)锟斤拷血锟杰斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟阶匡拷锟斤拷(ARB)锟斤拷锟斤拷卓锟斤拷锟斤拷锟斤拷锟斤拷锟窖癸拷锟斤拷锟斤拷锟斤拷锟叫э拷亟锟斤拷锟剿ブ⒆达拷锟斤拷倩锟�(C锟斤拷);应锟斤拷锟斤拷鼗锟斤拷芊锟斤拷锟剿ブ⒆达拷锟斤拷倩锟斤拷锟侥壳帮拷圆锟饺凤拷锟�(C锟斤拷)锟斤拷
2008锟斤拷ESC锟戒布锟侥★拷锟斤拷/锟斤拷锟斤拷锟斤拷衰锟斤拷霞锟斤拷锟斤拷锟街革拷稀锟街革拷锟斤拷锟侥壳叭憋拷锟斤拷煽锟斤拷锟斤拷锟斤拷品锟斤拷锟斤拷锟斤拷锟斤拷锟紿FNEF锟侥凤拷锟斤拷锟绞猴拷锟斤拷锟斤拷锟绞★拷应锟斤拷锟斤拷锟斤拷锟斤拷煽锟斤拷锟剿拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷芑锟斤拷锟斤拷锟斤拷锟斤拷锟窖硷拷水锟阶★拷锟斤拷锟解，锟斤拷锟狡合诧拷锟斤拷锟斤拷锟斤拷锟竭碉拷锟斤拷锟斤拷锟绞硷拷锟斤拷锟斤拷锟斤拷锟狡革拷血压锟斤拷锟侥硷拷缺血也锟斤拷锟斤拷要锟斤拷锟斤拷锟节合诧拷锟斤拷血压锟斤拷HFNEF锟斤拷锟竭ｏ拷锟狡硷拷锟斤拷锟斤拷锟斤拷锟斤拷锟窖癸拷锟斤拷锟�(通锟斤拷锟斤拷锟较讹拷锟街诧拷同锟斤拷锟矫伙拷锟狡碉拷药锟斤拷)锟斤拷ACEI锟斤拷(锟斤拷)ARB锟斤拷锟斤拷为一锟斤拷锟斤拷药锟斤拷
一锟斤拷锟芥及3023锟斤拷HFNEF锟斤拷锟竭碉拷锟斤拷锟剿わ拷锟轿匡拷锟斤拷锟斤拷锟斤拷芯锟�(CHARM-preserved)锟斤拷锟街ｏ拷锟斤拷锟斤拷锟斤拷沙坦锟斤拷锟斤拷3锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷要锟秸碉拷锟铰硷拷(锟斤拷血锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷衰住院)锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟届。锟斤拷一锟斤拷锟斤拷选850锟斤拷HFNEF锟斤拷锟竭碉拷PEP-CHF(锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷衰锟斤拷锟斤拷)锟叫撅拷也未锟斤拷证实锟斤拷应锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷3锟斤拷锟杰斤拷锟斤拷锟斤拷要锟秸碉拷锟铰硷拷(锟斤拷锟斤拷锟斤拷锟斤拷衰住院)锟斤拷锟斤拷锟绞★拷
4. HFNEF展锟斤拷锟斤拷i-PRESERVE锟叫撅拷锟斤拷锟斤拷锟斤拷
锟斤拷锟斤拷HFNEF锟斤拷锟斤拷通锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟揭肥猴拷锟斤拷锟斤拷锟窖拷芙锟斤拷锟斤拷锟饺╋拷锟酵低�(RAAS)锟侥硷拷锟筋，应锟斤拷ARB锟斤拷锟斤拷锟斤拷通锟斤拷锟斤拷锟絉AAS锟斤拷锟斤拷血压——HFNEF锟斤拷展锟斤拷锟斤拷要锟斤拷锟截ｏ拷锟斤拷锟斤拷影锟斤拷锟斤拷血锟斤拷锟截癸拷锟斤拷锟斤拷耍锟紸RB锟斤拷锟斤拷HFNEF锟斤拷锟斤拷锟斤拷锟斤拷锟角猴拷锟斤拷锟侥★拷目前锟斤拷锟节斤拷锟叫的讹拷沙坦锟斤拷锟斤拷HFNEF锟劫达拷锟叫撅拷—— i-PRESERVE锟斤拷锟斤拷为锟斤拷锟斤拷锟斤拷锟阶革拷锟斤拷锟斤拷模锟斤拷锟斤拷HFNEF锟斤拷前瞻锟斤拷锟斤拷锟剿わ拷锟轿匡拷锟斤拷锟斤拷锟斤拷芯锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟紸RB(锟斤拷沙坦)锟斤拷锟斤拷HFNEF锟斤拷锟斤拷锟绞★拷锟斤拷锟斤拷锟绞猴拷锟斤拷血锟斤拷住院锟绞碉拷锟斤拷锟矫硷拷锟斤拷药锟斤拷全锟皆★拷
锟斤拷锟斤拷锟阶硷拷锟斤拷芯锟斤拷锟狡硷拷锟秸碉拷
i-PRESERVE锟叫撅拷锟斤拷选4133锟斤拷锟斤拷锟斤拷≥60锟疥，LVEF≥45%锟斤拷纽约锟侥癸拷锟杰分硷拷(NYHA) ≥锟津级碉拷HFNEF锟斤拷锟竭ｏ拷锟斤拷锟皆伙拷锟斤拷应锟斤拷ACEI锟斤拷锟斤拷锟斤拷锟狡ｏ拷平锟斤拷锟斤拷锟绞憋拷锟轿�3.75锟疥。
锟叫撅拷锟斤拷萍锟酵�2锟斤拷锟叫撅拷锟斤拷要锟秸碉拷为全锟斤拷锟斤拷锟斤拷锟绞★拷锟截讹拷锟斤拷锟斤拷血锟杰硷拷锟斤拷(锟斤拷锟斤拷锟斤拷衰锟今化★拷锟斤拷锟饺讹拷锟斤拷锟侥斤拷痛锟斤拷锟侥硷拷锟斤拷锟斤拷锟斤拷锟斤拷锟皆伙拷锟斤拷锟斤拷锟斤拷锟斤拷失锟斤拷锟斤拷锟斤拷锟斤拷)住院锟绞伙拷锟叫撅拷锟斤拷住院锟节间发锟斤拷锟斤拷锟斤拷锟斤拷锟侥硷拷锟斤拷锟斤拷锟斤拷锟斤拷锟叫★拷锟斤拷要锟秸碉拷锟斤拷锟斤拷锟剿ワ拷盏锟�(锟斤拷衰锟斤拷锟斤拷锟斤拷住院)锟斤拷全锟斤拷锟斤拷锟斤拷锟绞★拷锟斤拷血锟斤拷锟斤拷锟斤拷锟绞★拷血锟斤拷锟秸碉拷(锟斤拷血锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟侥硷拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟�)锟斤拷锟斤拷锟斤拷指锟斤拷(锟斤拷锟斤拷锟斤拷锟斤拷锟紹NP锟斤拷)锟斤拷
锟叫撅拷锟斤拷锟斤拷
i-PRESERVE锟叫撅拷锟斤拷锟斤拷锟斤拷诮锟斤拷锟�11锟斤拷11锟斤拷锟斤拷AHA锟斤拷锟斤拷锟较癸拷锟斤拷锟斤拷
i-PRESERVE锟叫撅拷锟斤拷为目前锟斤拷模锟斤拷锟斤拷HFNEF锟叫撅拷锟斤拷锟斤拷为锟斤拷锟斤拷锟斤拷锟斤拷识锟斤拷锟斤拷锟较的硷拷锟斤拷锟结供锟斤拷锟斤拷锟斤拷锟矫碉拷锟斤拷息锟斤拷锟斤拷锟斤拷锟节硷拷HFNEF锟斤拷锟斤拷锟斤拷约锟斤拷贫锟斤拷锟斤拷锟斤拷缘锟斤拷锟斤拷撇锟斤拷浴锟斤拷锟斤拷鸥锟斤拷芯锟斤拷锟斤拷锟侥斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟紿FNEF锟劫达拷锟斤拷锟斤拷目锟秸癸拷锟� HFNEF锟侥凤拷锟斤拷锟斤拷锟狡伙拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷虾锟斤拷锟斤拷苹锟斤拷锟斤拷锟斤拷锟斤拷疲锟教斤拷锟角帮拷锟斤拷械锟紿FNEF锟斤拷锟叫革拷为锟斤拷锟绞碉拷未锟斤拷锟斤拷锟斤拷锟斤拷源锟斤拷锟叫癸拷医学锟斤拷坛锟斤拷锟斤拷
锟斤拷锟斤拷欧锟斤拷锟斤拷锟斤拷锟斤拷志锟斤拷锟斤拷European Heart Journal锟斤拷锟斤拷doi:10.1093/eurheartj/ehm037锟斤拷Walter J. Paulus锟斤拷Dirk L. Brutsaert锟斤拷
