Heart failure with preserved ejection fraction (HFpEF) is a complex clinical entity that is poorly understood yet present in up to 5.5% of the general population. Proven therapies for this disorder are lacking, even though it has a similar prognosis to that of heart failure with reduced ejection fraction (HFrEF). Innovative imaging techniques have provided in-depth understanding of the unique pattern of left ventricular mechanics in patients with HFpEF who progress through preclinical (Stages A to B) and clinical (Stages C to D) American College of Cardiology/American Heart Association heart failure stages. This review highlights the mechanical basis of this disorder from the cellular and myofiber level to chamber dysfunction. As each chamber of the heart is examined, specific biomarkers and echocardiographic parameters with diagnostic and prognostic values are discussed. Finally, novel phenotyping methods including machine learning are reviewed that integrate these mechanics into clinical groups to advise and treat patients.

中文翻译：

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LVEF正常且舒张功能障碍的患者的心肌力学。

保留射血分数（HFpEF）的心力衰竭是一个复杂的临床实体，人们对其了解甚少，但在高达5.5％的普通人群中仍然存在。尽管该疾病的预后与射血分数（HFrEF）降低的心力衰竭相似，但仍缺乏针对该疾病的可靠疗法。创新的成像技术已经深入了解了通过临床前（A至B期）和临床（C至D期）进展的HFpEF患者的左心室力学独特模式，美国心脏病学会/美国心脏协会心力衰竭阶段。这篇综述突出了从细胞和肌纤维水平到房室功能障碍的这种疾病的机械基础。当检查心脏的每个腔室时，讨论了具有诊断和预后价值的特定生物标志物和超声心动图参数。最后，对包括机器学习在内的新型表型方法进行了综述，这些方法将这些机制整合到了临床组中，以为患者提供建议和治疗。