Cardiorenal Syndrome Caused by Heart Failure with Preserved Ejection Fraction英文文献资料.docVIP

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Cardiorenal Syndrome Caused by Heart Failure with Preserved Ejection Fraction英文文献资料.doc

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Cardiorenal Syndrome Caused by Heart Failure with Preserved Ejection Fraction英文文献资料

SAGE-HindawiAccesstoResearch InternationalJournalofNephrology Volume2011,ArticleID634903,7pages doi:10.4061/2011/634903 ReviewArticle CardiorenalSyndromeCausedbyHeartFailurewith PreservedEjectionFraction ChiaraLazzeri, Sera?naValente, RobertoTarquini, andGianFrancoGensini 1 1 2 1 1 2 HeartandVesselDepartment,AziendaOspedaliero-UniversitariaCareggi,50134Florence,Italy DepartmentofInternalMedicine,UniversityofFlorence,50134Florence,Italy CorrespondenceshouldbeaddressedtoChiaraLazzeri,lazzeric@libero.it Received25August2010;Accepted3January2011 AcademicEditor:ClaudioRonco Copyright?2011ChiaraLazzerietal.ThisisanopenaccessarticledistributedundertheCreativeCommonsAttributionLicense, whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperlycited. Sincecardiorenaldysfunctionisusuallysecondarytomultiplefactorsactinginconcert(andnotonlyreducedcardiacoutput) inthepresentpaperwearegoingtofocusontheinterrelationshipbetweenheartfailurewithnormalejectionfractionandthe developmentofcardiorenalsyndrome.Thecoexistenceofrenalimpairmentinheartfailurewithpreservedejectionfraction(CRS type2and4)iscommonespeciallyinolderfemaleswithhypertensionand/ordiabetes.Itcanbehypothesizedthattheincidence ofthisdiseaseassociationisgrowing,whileclinicaltrialsenrollingthesepatientsarestilllacking.Themainmechanismsthought tobeinvolvedinthepathophysiologyofthisconditionarerepresentedbytheincreaseofintra-abdominalandcentralvenous pressureandtheactivationoftherenin-angiotensinsystem.Di?erentlyfromCRSinheartfailurewithreducedejectionfraction, theinvolvementofthekidneymaybeunder-diagnosedinpatientswith heartfailureandpreserved ejection fractionandthe optimaltherapeuticstrategyinthiscondition,thoughchallenging,isfartobecompletelyelucidated.Furtherstudiesareneeded toassessthebesttherapeuticregimeninpatientswithrenaldysfunction(andworsening)andheartfailureandpreservedejection fraction. 1.Introducti