medicina57巻10号

2020年09月発行

特集 循環器診療2020—どこまで攻めて，どこから引くか？ 心不全

心不全診療の未来

著者： 小保方優¹

所属機関： ¹群馬大学医学部附属病院循環器内科

ページ範囲：P.1682 - P.1684

Point
◎HFpEF患者にはHFrEFに効果的な画一的な治療（“one-size-fits-all”アプローチ）は効果が乏しい．
◎この一番の理由はHFpEFが心臓・心臓外のさまざまな異常が混ざり合ったheterogenousな症候群であることだと考えられている．
◎このheterogenousなHFpEFを比較的均一なサブグループに分類し，個別治療をするフェノタイピングが今後のHFpEF治療の鍵である．

参考文献

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9）Yancy CW, et al：2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure；A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. Circulation 136：e137-e161, 2017

10）Selvaraj S, et al：Systolic blood pressure in heart failure with preserved ejection fraction treated with sacubitril/valsartan. J Am Coll Cardiol 75：1644-1656, 2020

11）Fukuta H, et al：The effect of statins on mortality in heart failure with preserved ejection fraction；A meta-analysis of propensity score analyses. Int J Cardiol 214：301-306, 2016

12）Hwang SJ, et al：Implications of coronary artery disease in heart failure with preserved ejection fraction. J Am Coll Cardiol 63：2817-2827, 2014

13）Machino-Ohtsuka T, et al：Relationships between maintenance of sinus rhythm and clinical outcomes in patients with heart failure with preserved ejection fraction and atrial fibrillation. J Cardiol 74：235-244, 2019