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Review
. 2021 Jul 6;19(1):291.
doi: 10.1186/s12967-021-02935-x.

Heart failure with preserved ejection fraction based on aging and comorbidities

Ying Lin #  1 , Shihui Fu #  2   3 , Yao Yao #  4   5 , Yulong Li #  6 , Yali Zhao  7 , Leiming Luo  8
Affiliations
Review

Heart failure with preserved ejection fraction based on aging and comorbidities

Ying Lin et al. J Transl Med. .

Abstract

Heart failure (HF) with preserved ejection fraction (HFpEF) is a leading cause of hospitalizations and mortality when diagnosed at the age of ≥ 65 years. HFpEF represents multifactorial and multisystemic syndrome and has different pathophysiology and phenotypes. Its diagnosis is difficult to be established based on left ventricular ejection fraction and may benefit from individually tailored approaches, underlying age-related changes and frequent comorbidities. Compared with the rapid development in the treatment of heart failure with reduced ejection fraction, HFpEF presents a great challenge and needs to be addressed considering the failure of HF drugs to improve its outcomes. Further extensive studies on the relationships between HFpEF, aging, and comorbidities in carefully phenotyped HFpEF subgroups may help understand the biology, diagnosis, and treatment of HFpEF. The current review summarized the diagnostic and therapeutic development of HFpEF based on the complex relationships between aging, comorbidities, and HFpEF.

Keywords: Aging; Comorbidities; Diagnosis; Heart failure with preserved ejection fraction; Treatment.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Heart Failure Association Pretest assessment, Echocardiography, and natriuretic peptide, Functional testing, Final etiology (HFA-PEFF): a diagnostic procedure for heart failure with preserved ejection fraction HFpEF. HF heart failure, AF atrial fibrillation, CAD coronary artery disease, MetS metabolic syndrome, CKD chronic kidney disease, COPD chronic obstructive pulmonary disease, SDB sleep-disordered breathing, NPs natriuretic peptides, Hb hemoglobin, HbA1C hemoglobin A1C, Scr serum creatinine, eGFR estimated glomerular filtration rate, ALT alanine aminotransferase, TSH thyroid stimulating hormone, LVEF left ventricular ejection fraction, LVH left ventricular hypertrophy, LAE left atrial enlargement, 6MWT 6 min walk test, CPET cardiopulmonary exercise testing, TR tricuspid regurgitation, PASP pulmonary artery systolic pressure, GLS global longitudinal strain, LAVI left atrial volume index, LVMI left ventricular mass index, RWT relative wall thickness, LV left ventricular, SR sinus rhythm, NT-proBNP N-terminal pro-B-type natriuretic peptide, BNP B-type natriuretic peptide, LVEDP left ventricular end-diastolic pressure, PCWP pulmonary capillary wedge pressure, CT computed tomography, PET positron emission tomography, HCM hypertrophic cardiomyopathy, RCM restrictive cardiomyopathy, CHD congenital heart disease, VHD valvular heart disease
See this image and copyright information in PMC

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