Heart failure with preserved ejection fraction: insights from recent clinical researches

Abstract

Heart failure (HF) with preserved ejection fraction (HFpEF) accounts for nearly half of the cases of HF and its incidence might be increasing with the aging society. Patients with HFpEF present with significant symptoms, including exercise intolerance, impaired quality of life, and have a poor prognosis as well as frequent hospitalization and increased mortality compared with HF with reduced ejection fraction. The concept of HFpEF is still evolving and may be a virtual complex rather than a real systemic disorder. Thus, beyond solely targeting cardiac abnormalities management strategies need to be extended, such as left ventricular diastolic dysfunction. In this review, we examine new diagnostic algorithms, pathophysiology, current management status, and ongoing trials based on heterogeneous pathophysiology and etiology in HFpEF.

Keywords: Heart failure; Preserved ejection fraction; Therapy.

Figure 1.

Schematic pathophysiology of heart failure with preserved ejection fraction. LV, left ventricular; RV, right ventricular.

Figure 2.

Cellular mechanism of heart failure with preserved ejection fraction. CAD, coronary artery disease; ROS, reactive oxygen species; NO, nitric oxide; TGF-β transforming growth factor-β; sGC, soluble guanylate cyclase; cGMP, cyclic quanosine monophosphate; PKG, protein kinase G.