May 23, 2019Open Access
View Full PaperHeart Failure With Preserved Ejection Fraction In Perspective
Key Points
- The aim is to explore heart failure with preserved ejection fraction and its impact over the past two decades.
- Comprehensive review of epidemiological data
- Analysis of pathophysiological mechanisms
- Overview of current and planned therapeutic trials
- Heart failure with preserved ejection fraction is associated with major adverse events even in normal ejection fraction cases.
- The recognition of this issue has led to increased clinical trials and studies in the last 20 years.
- Future research may improve outcomes through phenotyping and genotyping of heart failure subpopulations.
Abstract
Approximately half of the patients with signs and symptoms of heart failure have a left ventricular ejection fraction that is not markedly abnormal. Despite the historically initial surprise, heightened risks for heart failure specific major adverse events occur across the broad range of ejection fraction, including normal. The recognition of the magnitude of the problem of heart failure with preserved ejection fraction in the past 20 years has spurred an explosion of clinical investigation and growing intensity of informative outcome trials. This article addresses the historic development of this component of the heart failure syndrome, including the epidemiology, pathophysiology, and existing and planned therapeutic studies. Looking forward, more specific phenotyping and even genotyping of subpopulations should lead to improvements in outcomes from future trials.