Key result
Heart failure with preserved ejection fraction is a heterogeneous clinical syndrome lacking mortality-reducing pharmacologic interventions, necessitating phenotype-guided treatment strategies.
Why the study?
Despite numerous studies on pathophysiology, diagnosis, and treatment, no current pharmacologic interventions reduce mortality in HFpEF, leaving it as a major unmet clinical need.
This review emphasizes the importance of phenotyping and advanced diagnostic testing, such as diastolic stress echocardiography, to better understand and manage the heterogeneous syndrome of HFpEF.
HFpEF heterogeneity warrants cautious phenotyping before therapy selection; leaves open validation of responsive subgroups in targeted trials.
Heart failure with preserved ejection fraction (HFpEF) has recently been recognized as the single greatest unmet need in cardiovascular medicine. As the population ages and the comorbidity increases, the prevalence of HFpEF increases considerably. Even though there have been large numbers of studies on pathophysiology, diagnosis, and treatment of HFpEF for latest years, there are no current pharmacologic interventions that can reduce mortality. HFpEF is currently understood as a heterogeneous syndrome originated from the interplay of cardiac and extracardiac abnormalities recognized by systemic inflammation, endothelial and coronary microvascular dysfunction, cardiomyocyte dysfunction and skeletal muscle dysfunction. The difficult "jigsaw puzzle" called HFpEF has been filled with some pieces, but it is still not enough to meet clinical needs. Here, we review recent evidences and unsolved problems about HFpEF to improve our understanding of HFpEF. Finally, we hope to accelerate to completion of the problematic "jigsaw puzzle".
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Chi Young Shim (2020) conducted a review in Heart failure with preserved ejection fraction (HFpEF). Heart failure with preserved ejection fraction is a heterogeneous clinical syndrome lacking mortality-reducing pharmacologic interventions, necessitating phenotype-guided treatment strategies.
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