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Int J Angiol 2022; 31(03): 166-178
DOI: 10.1055/s-0042-1756173
Invited Article

Current Management of Heart Failure with Preserved Ejection Fraction

Akash H. Patel 
1   Department of Internal Medicine, University of California Irvine Medical Center, Orange, California
,
Balaji Natarajan
2   Department of Cardiology, University of California Riverside School of Medicine, Riverside, California
3   Department of Cardiology, St. Bernardine Medical Center, San Bernardino, California
,
Ramdas G. Pai 
2   Department of Cardiology, University of California Riverside School of Medicine, Riverside, California
3   Department of Cardiology, St. Bernardine Medical Center, San Bernardino, California
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Abstract

Heart failure with preserved ejection fraction (HFpEF) encompasses nearly half of heart failure (HF) worldwide, and still remains a poor prognostic indicator. It commonly coexists in patients with vascular disease and needs to be recognized and managed appropriately to reduce morbidity and mortality. Due to the heterogeneity of HFpEF as a disease process, targeted pharmacotherapy to this date has not shown a survival benefit among this population. This article serves as a comprehensive historical review focusing on the management of HFpEF by reviewing past, present, and future randomized controlled trials that attempt to uncover a therapeutic value. With a paradigm shift in the pathophysiology of HFpEF as an inflammatory, neurohormonal, and interstitial process, a phenotypic approach has increased in popularity focusing on the treatment of HFpEF as a systemic disease. This article also addresses common comorbidities associated with HFpEF as well as current and ongoing clinical trials looking to further elucidate such links.

Keywords

HFpEF - diastolic dysfunction - preserved ejection fraction - heart failure - BNP - pathophysiology - treatment of HFpEF


Publication History

Article published online:
23 September 2022

© 2022. International College of Angiology. This article is published by Thieme.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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