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Review
. 2024 Apr 3:10:e05.
doi: 10.15420/cfr.2023.13. eCollection 2024.

The Therapy and Management of Heart Failure with Preserved Ejection Fraction: New Insights on Treatment

Giulio Balestrieri  1 , Raul Limonta  2 , Enrico Ponti  3 , Anna Merlo  2 , Edoardo Sciatti  1 , Salvatore D'Isa  1 , Mauro Gori  1 , Gavino Casu  3 , Cristina Giannattasio  4 , Michele Senni  1   4 , Emilia D'Elia  1
Affiliations
Review

The Therapy and Management of Heart Failure with Preserved Ejection Fraction: New Insights on Treatment

Giulio Balestrieri et al. Card Fail Rev. .

Abstract

Heart failure with preserved ejection fraction (HFpEF) is a clinical syndrome characterised by the presence of diastolic dysfunction and elevated left ventricular filling pressure, in the setting of a left ventricular ejection fraction of at least 50%. Despite the epidemiological prevalence of HFpEF, a prompt diagnosis is challenging and many uncertainties exist. HFpEF is characterised by different phenotypes driven by various cardiac and non-cardiac comorbidities. This is probably the reason why several HFpEF clinical trials in the past did not reach strong outcomes to recommend a single therapy for this syndrome; however, this paradigm has recently changed, and the unmet clinical need for HFpEF treatment found a proper response as a result of a new class of drug, the sodium-glucose cotransporter 2 inhibitors, which beneficially act through the whole spectrum of left ventricular ejection fraction. The aim of this review was to focus on the therapeutic target of HFpEF, the role of new drugs and the potential role of new devices to manage the syndrome.

Keywords: Heart failure with preserved ejection fraction; drugs; management; therapy.

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Conflict of interest statement

Disclosure: The authors have no conflicts of interest to declare.

Figures

Figure 1:
Figure 1:. Three Heart Failure with Preserved Ejection Fraction Phenotypes
Figure 2:
Figure 2:. Heart Failure with Preserved Ejection Fraction Pathophysiology, Clinical Manifestations and Possible Sites of Intervention
See this image and copyright information in PMC

References

    1. Redfield MM, Borlaug BA. Heart failure with preserved ejection fraction: a review. JAMA. 2023;329:827–38. doi: 10.1001/jama.2023.2020. - DOI - PubMed
    1. Gori M, D’Elia E, Zambelli G, Senni M. Heart failure with preserved ejection fraction: an update on diagnosis and treatment. G Ital Cardiol (Rome) 2020;21:119–27. doi: 10.1714/3300.32705. [in Italian]. - DOI - PubMed
    1. Reddy YNV, Carter RE, Obokata M et al. A simple, evidence-based approach to help guide diagnosis of heart failure with preserved ejection fraction. Circulation. 2018;138:861–70. doi: 10.1161/CIRCULATIONAHA.118.034646. - DOI - PMC - PubMed
    1. Pieske B, Tschöpe C, de Boer RA et al. How to diagnose heart failure with preserved ejection fraction: the HFA-PEFF diagnostic algorithm: a consensus recommendation from the Heart Failure Association (HFA) of the European Society of Cardiology (ESC). Eur Heart J. 2019;40:3297–317. doi: 10.1093/eurheartj/ehz641. - DOI - PubMed
    1. Kittleson MM, Panjrath GS, Amancherla K et al. 2023 ACC expert consensus decision pathway on management of heart failure with preserved ejection fraction: a report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol. 2023;81:1835–78. doi: 10.1016/j.jacc.2023.03.393. - DOI - PubMed