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Review
. 2023 May 9;81(18):1810-1834.
doi: 10.1016/j.jacc.2023.01.049. Epub 2023 Apr 19.

Heart Failure With Preserved Ejection Fraction: JACC Scientific Statement

Barry A Borlaug  1 , Kavita Sharma  2 , Sanjiv J Shah  3 , Jennifer E Ho  4
Affiliations
Free article
Review

Heart Failure With Preserved Ejection Fraction: JACC Scientific Statement

Barry A Borlaug et al. J Am Coll Cardiol. .
Free article

Abstract

The incidence and prevalence of heart failure with preserved ejection fraction (HFpEF) continue to rise in tandem with the increasing age and burdens of obesity, sedentariness, and cardiometabolic disorders. Despite recent advances in the understanding of its pathophysiological effects on the heart, lungs, and extracardiac tissues, and introduction of new, easily implemented approaches to diagnosis, HFpEF remains under-recognized in everyday practice. This under-recognition presents an even greater concern given the recent identification of highly effective pharmacologic-based and lifestyle-based treatments that can improve clinical status and reduce morbidity and mortality. HFpEF is a heterogenous syndrome and recent studies have suggested an important role for careful, pathophysiological-based phenotyping to improve patient characterization and to better individualize treatment. In this JACC Scientific Statement, we provide an in-depth and updated examination of the epidemiology, pathophysiology, diagnosis, and treatment of HFpEF.

Keywords: diagnosis; epidemiology; heart failure with preserved ejection fraction; pathophysiology; treatment.

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Conflict of interest statement

Funding Support and Author Disclosures Supported in part by National Institutes of Health (NIH) grants R01 HL128526 and U01 HL160226 (Dr Borlaug), U54 HL160273, R01 HL107577, R01 HL127028, R01 HL140731, R01 HL149423 (Dr Shah), R01 HL134893, R01 HL140224, R01 HL160003, K24 HL153669 (Dr Ho); and by the U.S. Department of Defense: W81XWH2210245 (Dr Borlaug). Dr Borlaug has received research support from the NIH and the United States Department of Defense; and has received research grant funding from AstraZeneca, Axon, GlaxoSmithKline, Medtronic, Mesoblast, Novo Nordisk, Rivus, and Tenax Therapeutics. Dr Borlaug has served as a consultant for Actelion, Amgen, Aria, Axon Therapies, BD, Boehringer Ingelheim, Cytokinetics, Edwards Lifesciences, Eli Lilly, Imbria, Janssen, Merck, Novo Nordisk, NGM, NXT, and VADovations; and is named inventor (U.S. Patent no. 10,307,179) for the tools and approach for a minimally invasive pericardial modification procedure to treat HF. Dr Sharma has received research grants from Amgen and the American Heart Association; and has served as a consultant for Alleviant, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Novartis, NovoNordisk, and Rivus. Dr Shah has received research grants from the NIH, Actelion, AstraZeneca, Corvia, Novartis, and Pfizer; and has received consulting fees from Abbott, Actelion, AstraZeneca, Amgen, Aria CV, Axon Therapies, Bayer, Boehringer Ingelheim, Boston Scientific, Bristol Myers Squibb, Cardiora, Coridea, CVRx, Cyclerion, Cytokinetics, Edwards Lifesciences, Eidos, Eisai, Imara, Impulse Dynamics, Intellia, Ionis, Ironwood, Lilly, Merck, MyoKardia, Novartis, Novo Nordisk, Pfizer, Prothena, Regeneron, Rivus, Sanofi, Shifamed, Tenax, Tenaya, and United Therapeutics. Dr Ho has received research grants from the NIH and Bayer, AG.

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