Key result
Heart failure with preserved ejection fraction is a complex syndrome driven by left ventricular dysfunction and comorbidities, with hypertension as the primary modifiable risk factor.
This review highlights the pathophysiological mechanisms, diagnostic challenges, and lack of proven pharmacological therapies for heart failure with preserved ejection fraction.
Heart failure with preserved left ventricular ejection fraction (HFPEF) represents a huge medical problem, especially in light of an increasing elderly population. Dysfunction of both left ventricular filling and ejection, combined with adverse loading conditions related to advanced age, arterial hypertension, diabetes mellitus, obesity and atrial fibrillation are fundamental pathophysiological mechanisms. Hypertension is probably the most important modifiable risk factor. The diagnosis has largely been based on signs of increased left ventricular filling pressure. Additional matters of debate are the interpretation of left ventricular ejection fraction in concentric remodelling and the cut-off used for the definition of HFPEF, as well as inconsistencies related to prevalence and prognosis, and lack of benefit of drugs in randomized trials.
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Johannes Soma (2010) conducted a review in Heart failure with preserved left ventricular ejection fraction (HFPEF). Heart failure with preserved ejection fraction is a complex syndrome driven by left ventricular dysfunction and comorbidities, with hypertension as the primary modifiable risk factor.
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