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Review
. 2016 Apr 15:12:129-41.
doi: 10.2147/VHRM.S83662. eCollection 2016.

Targeting heart failure with preserved ejection fraction: current status and future prospects

Manreet Kanwar  1 , Claire Walter  1 , Megan Clarke  1 , Maria Patarroyo-Aponte  1
Affiliations
Review

Targeting heart failure with preserved ejection fraction: current status and future prospects

Manreet Kanwar et al. Vasc Health Risk Manag. .

Abstract

Heart failure with preserved ejection fraction (HFpEF) portrays a significant burden in terms of prevalence, morbidity, mortality, and health care costs. There is a lack of consensus on the basic pathophysiology, definition, and therapeutic targets for therapy for this syndrome. To date, there are no approved therapies available for reducing mortality or hospitalization for these patients. Several clinical trials have recently started to try and bridge this major gap. There is an urgent need to focus on drug and device development for HFpEF as well as to understand HFpEF pathophysiology.

Keywords: HFpEF therapies; diastolic dysfunction.

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Figures

Figure 1
Figure 1
Multiple factors that contribute to the pathophysiology of HFpEF. Abbreviations: LV, left ventricular; ECM, extracellular matrix; HFpEF, Heart failure with preserved ejection fraction; CV, cardiovascular.
Figure 2
Figure 2
Effect of changes in arterial elastance (Ea) in SBP and SV. Notes: (A) Normal pressure–volume curve showing the relation between Ea and Ees. (B) Pressure–volume curve in a patient with HFpEF showing a significant drop in SBP with mild increase in SV after decrease in Ea (red line). (C) Pressure–volume curve in a patient with HFrEF with increase in SV and minimal change in SBP after decrease in Ea with vasodilator therapy. Abbreviations: SBP, systolic blood pressure; SV, stroke volume; HFpEF, heart failure with preserved ejection fraction; HFrEF, heart failure with reduced ejection fraction.
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References

    1. Steinberg BA, Zhao X, Heidenreich PA, et al. Get With the Guidelines Scientific Advisory Committee and Investigators Trends in patients hospitalized with heart failure and preserved left ventricular ejection fraction: prevalence, therapies, and outcomes. Circulation. 2012;126(1):65–75. - PubMed
    1. Solomon SD, Anavekar N, Skali H, et al. Candesartan in Heart Failure Reduction in Mortality (CHARM) Investigators Influence of ejection fraction on cardiovascular outcomes in a broad spectrum of heart failure patients. Circulation. 2005;112(24):3738–3744. - PubMed
    1. Campbell RT, Jhund PS, Castagno D, Hawkins NM, Petrie MC, McMurray JJ. What have we learned about patients with heart failure and preserved ejection fraction from DIG-PEF, CHARM-preserved, and I-PRESERVE? J Am Coll Cardiol. 2012;60(23):2349–2356. - PubMed
    1. Kawaguchi M, Hay I, Fetics B, Kass DA. Combined ventricular systolic and arterial stiffening in patients with heart failure and preserved ejection fraction: implications for systolic and diastolic reserve limitations. Circulation. 2003;107(5):714–720. - PubMed
    1. Melenovsky V, Borlaug BA, Rosen B, et al. Cardiovascular features of heart failure with preserved ejection fraction versus nonfailing hypertensive left ventricular hypertrophy in the urban Baltimore community: the role of atrial remodeling/dysfunction. J Am Coll Cardiol. 2007;49(2):198–207. - PubMed

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