Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Jun 5;53(7):e9646.
doi: 10.1590/1414-431X20209646. eCollection 2020.

Heart failure with preserved ejection fraction: an update on pathophysiology, diagnosis, treatment, and prognosis

Chao Ma  1   2 , Huan Luo  3 , Lei Fan  4 , Xiaoyan Liu  5 , Chengshan Gao  5
Affiliations
Review

Heart failure with preserved ejection fraction: an update on pathophysiology, diagnosis, treatment, and prognosis

Chao Ma et al. Braz J Med Biol Res. .

Erratum in

Abstract

Heart failure (HF) with preserved ejection fraction (HFpEF) is a clinical syndrome in which patients have symptoms and signs of HF with normal or near-normal left ventricular ejection fraction (LVEF ≥50%). Roughly half of all patients with HF worldwide have an LVEF ≥50% and nearly half have an LVEF <50%. Thanks to the increased scientific attention about the condition and improved characterization and diagnostic tools, the incidence of HF with reduced ejection fraction (HFrEF) dropped while that of HFpEF has increased by 45%. HFpEF has no single guideline for diagnosis or treatment, the patient population is heterogeneously and inconsistently described, and longitudinal studies are lacking. To better understand and overcome the disease, in this review, we updated the latest knowledge of HFpEF pathophysiology, introduced the existing promising diagnostic methods and treatments, and summarized its prognosis by reviewing the most recent cohort studies.

PubMed Disclaimer

Figures

Figure 1
Figure 1. Description of the H2FPEF score and point allocations for each clinical characteristic (top), with associated probability of having heart failure with preserved ejection fraction (HFpEF) based on the total score as estimated from the model (bottom).
Figure 2
Figure 2. Approach to diagnosis of heart failure with preserved ejection fraction (HFpEF). LVEF: left ventricular ejection fraction; BNP: brain natriuretic peptide; NT-proBNP: N-terminal pro-brain natriuretic peptide; PCWP: pulmonary capillary wedge pressure.
Figure 3
Figure 3. Mechanisms in heart failure with preserved ejection fraction (HFpEF) outlined in this review. LV: left ventricle; RV: right ventricle.
See this image and copyright information in PMC

References

    1. Metra M, Teerlink JR. Heart failure. Lancet. 2017;390:1981–1995. doi: 10.1016/S0140-6736(17)31071-1. - DOI - PubMed
    1. Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JGF, Coats AJS, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2016;37:2129–2200. doi: 10.1093/eurheartj/ehw128. - DOI - PubMed
    1. Amgalan D, Kitsis RN. A mouse model for the most common form of heart failure. Nature. 2019;568:324–325. doi: 10.1038/d41586-019-00983-4. - DOI - PMC - PubMed
    1. Borlaug BA. The pathophysiology of heart failure with preserved ejection fraction. Nat Rev Cardiol. 2014;11:507–515. doi: 10.1038/nrcardio.2014.83. - DOI - PubMed
    1. Borlaug BA, Redfield MM, Melenovsky V, Kane GC, Karon BL, Jacobsen SJ, et al. Longitudinal changes in left ventricular stiffness: a community-based study. Circ Heart Fail. 2013;6:944–952. doi: 10.1161/CIRCHEARTFAILURE.113.000383. - DOI - PMC - PubMed