纠正危险因素是预防或者延缓临床心力衰竭发生的关键。一旦确诊心力衰竭，射血分数保留的心衰患者的预后与收缩功能受损患者相似。射血分数保留组与减低组的1年及5年死亡率、心衰再住院率和住院并发症均相近。[7]Owan TE, Hodge DO, Herges RM, et al. Trends in prevalence and outcome of heart failure with preserved ejection fraction. N Engl J Med. 2006;355:251-259.http://www.nejm.org/doi/full/10.1056/NEJMoa052256#t=articlehttp://www.ncbi.nlm.nih.gov/pubmed/16855265?tool=bestpractice.com[10]Bhatia RS, Tu JV, Lee DS, et al. Outcome of heart failure with preserved ejection fraction in a population-based study. N Engl J Med. 2006;355:260-269.http://www.nejm.org/doi/full/10.1056/NEJMoa051530#t=articlehttp://www.ncbi.nlm.nih.gov/pubmed/16855266?tool=bestpractice.com
N末端脑钠尿肽前体(NT-proBNP)水平与患者全因死亡率及心力衰竭的住院治疗率呈正相关。[57]Cleland JG, Taylor J, Freemantle N, et al. Relationship between plasma concentrations of N-terminal pro brain natriuretic peptide and the characteristics and outcome of patients with a clinical diagnosis of diastolic heart failure: a report from the PEP-CHF study. Eur J Heart Fail. 2012;14:487-494.http://onlinelibrary.wiley.com/doi/10.1093/eurjhf/hfs049/fullhttp://www.ncbi.nlm.nih.gov/pubmed/22505395?tool=bestpractice.com
贫血可能提示预后不良和/或死亡率增加，应给予适当治疗。[86]von Haehling S, van Veldhuisen DJ, Roughton M, Babalis D, et al. Anaemia among patients with heart failure and preserved or reduced ejection fraction: results from the SENIORS study. Eur J Heart Fail. 2011;13:656-663.http://onlinelibrary.wiley.com/doi/10.1093/eurjhf/hfr044/fullhttp://www.ncbi.nlm.nih.gov/pubmed/21613429?tool=bestpractice.com
心力衰竭患者中抑郁症患病率高，且与更高的住院率相关。因此，应对患者进行抑郁症筛查和早期干预。[87]Johnson TJ, Basu S, Pisani BA, et al. Depression predicts repeated heart failure hospitalizations. J Card Fail. 2012;18:246-252.http://www.ncbi.nlm.nih.gov/pubmed/22385946?tool=bestpractice.com
一项Meta分析显示，与松弛异常或正常模式相比，假性正常化的舒张期充盈模式与死亡风险增加相关，且该风险大小与限制性充盈模式相似。[88]Somaratne JB, Whalley GA, Poppe KK, et al. Pseudonormal mitral filling is associated with similarly poor prognosis as restrictive filling in patients with heart failure and coronary heart disease: a systematic review and meta-analysis of prospective studies. J Am Soc Echocardiogr. 2009;22:494-498.http://www.ncbi.nlm.nih.gov/pubmed/19307097?tool=bestpractice.com
尚无治疗可降低射血分数保留的心力衰竭患者的死亡率。近年来，射血分数减低患者的生存率有升高趋势，但射血分数保留心力衰竭患者的生存率没有改变。[7]Owan TE, Hodge DO, Herges RM, et al. Trends in prevalence and outcome of heart failure with preserved ejection fraction. N Engl J Med. 2006;355:251-259.http://www.nejm.org/doi/full/10.1056/NEJMoa052256#t=articlehttp://www.ncbi.nlm.nih.gov/pubmed/16855265?tool=bestpractice.com
