射血分数保留型心力衰竭(heart failure with preserved ejection fraction,HFpEF)是一种具有显著异质性的临床综合征,其全球发病率正随着老龄化进程的加快以及糖尿病、高血压等危险因素的广泛流行而持续上升。尽管学界对HFpEF的病理生理机制已有逐步深入的认识, 但其完整的疾病演进网络仍未完全阐明, 且迄今缺乏针对性的有效治疗手段。当前临床诊断多借鉴射血分数降低型心力衰竭(heart failure with reduced ejection fraction,HFrEF)的诊断框架, 然而该策略 可能难以准确反映HFpEF的独特病理生理特征。值得关注的是,越来越多的研究表明, 生物标志物在HFpEF的精准诊断与风险分层中展现出广阔的应用前景。因此, 本综述系统整合了生物标志物在HFpEF诊断与预后评估中的增量价值, 为构建多标志物联合模型提供循证支持。

Heart failure with preserved ejection fraction (HFpEF) is a clinical syndrome characterized by considerable heterogeneity. Its global incidence continues to rise due to the accelerating aging population and the increasing prevalence of risk factors such as diabetes and hypertension. Although there has been gradual progress in understanding the pathophysiological mechanisms of HFpEF, its full disease progression network remains incompletely understood, and effective targeted therapeutic strategies are still lacking. Currently, clinical diagnosis of HFpEF often relies on the diagnostic framework established for heart failure with reduced ejection fraction (HFrEF). Yet, this approach may not adequately capture the distinct pathophysiological features of HFpEF. Notably, recent studies have increasingly highlighted the promising role of biomarkers in enabling more precise diagnosis and improved risk stratification of HFpEF. Therefore, this review systematically summarizes the incremental value of biomarkers in the diagnosis and prognostic evaluation of HFpEF, providing evidence-based support for the development of multi-biomarker integrated models.