HFp2EF: heart failure with pulmonary dysfunction and preserved ejection fraction?

Lung–HFpEF pathophenotype. Converging lines of data indicate that among the large universe of patients with heart failure and preserved left ventricular ejection fraction (HFpEF), a sizeable subgroup are characterized by intrinsic lung dysfunction assessed by spirometry that is important clinically. In this issue of the journal, Eckhardt and colleagues show that heart failure mortality and heart failure hospitalization risk are elevated substantially in patients with this lung–HFpEF pathophenotype. These findings merit further appraisal and integration into the clinical assessment of HFpEF, including standardization of pulmonary function testing of at-risk patients as well as further data that clarify the extent to which lung dysfunction is a modifiable contributor to HFpEF clinical burden. FEV1, forced expiratory volume in 1 s; FVC, forced vital capacity. Panels 2 and 3 from Johns Hopkins School of Medicine’s ‘Interactive Respiratory Physiology’ at https://oac.med.jhmi.edu/res_phys/encyclopedia/forcedexpiration/forcedexpiration.