Multiple hormone deficiency syndrome: a novel topic in chronic heart failure

摘要

Heart failure (HF) is described as a clinical syndrome characterized by typical symptoms (e.g., ankle swelling,fatigue or dyspnea) or signs (e.g., peripheral edema, pulmonary crackles or elevated jugular venous pressure), inwhich structural and/or functional cardiac abnormalities induce an impairment of cardiac output or an increaseof intracardiac pressures at rest and/or during stress [1 , 2] . Importantly, due to different underlying etiologies,demographics, co-morbidities, and response to therapies, the main terminology used to describe HF is based onmeasurement of left ventricle ejection fraction (EF). Classically, patients with normal EF (typically considered as≥50%) are said to have HF with preserved EF (HFpEF), with those with reduced EF (typically considered as<40%) termed as HF with reduced EF (HFrEF). In the latest European Society of Cardiology guidelines, caseswhere EF lies between 40 and 49%, previously considered as a ‘gray area’, are now defined as HF with mid-rangeEF (HFmEF) [1] .