Heart failure with preserved ejection fraction: New approaches to diagnosis and management.
Abstract
The majority of older patients who develop heart failure (HF), particularly older
women, have a preserved left ventricular ejection fraction (HFpEF). Patients with
HFpEF have severe symptoms of exercise intolerance, poor quality-of-life, frequent
hospitalizations, and increased mortality. The prevalence of HFpEF is increasing and
its prognosis is worsening. However, despite its importance, our understanding of
the pathophysiology of HFpEF is incomplete, and drug development has proved immensely
challenging. Currently, there are no universally accepted therapies that alter the
clinical course of HFpEF. Originally viewed as a disorder due solely to abnormalities
in left ventricular (LV) diastolic function, our understanding has evolved such that
HFpEF is now understood as a systemic syndrome, involving multiple organ systems,
likely triggered by inflammation and with an important contribution of aging, lifestyle
factors, genetic predisposition, and multiple-comorbidities, features that are typical
of a geriatric syndrome. HFpEF is usually progressive due to complex mechanisms of
systemic and cardiac adaptation that vary over time, particularly with aging. In this
review, we examine evolving data regarding HFpEF that may help explain past challenges
and provide future directions to care patients with this highly prevalent, heterogeneous
clinical syndrome.
Type
Journal articleSubject
HumansStroke Volume
Treatment Outcome
Risk Assessment
Risk Factors
Predictive Value of Tests
Age Factors
Recovery of Function
Aging
Ventricular Function, Left
Time Factors
Quality of Life
Aged
Aged, 80 and over
Female
Male
Heart Failure
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https://hdl.handle.net/10161/26049Published Version (Please cite this version)
10.1002/clc.23321Publication Info
Upadhya, Bharathi; & Kitzman, Dalane W (2020). Heart failure with preserved ejection fraction: New approaches to diagnosis and management.
Clinical cardiology, 43(2). pp. 145-155. 10.1002/clc.23321. Retrieved from https://hdl.handle.net/10161/26049.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Bharathi Upadhya
Associate Professor of Medicine

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