Heart failure with preserved ejection fraction: A review of clinical status and meta-analysis of diagnosis by myocardial strain and effect of medication on mortality and hospitalization

Heart failure (HF)-related morbidity, mortality and health care burden remains unacceptably high, and with a rapidly increasing prevalence, the burden will increase substantially over the next few decades. Strongly associated with most of the increasing prevalence is an expanding population of HF patients with preserved ejection fraction (HFpEF), mostly precipitated or aggravated by a rapid increase in lifestyle and/or genetic conditions particularly hypertension, obesity and metabolic syndromes. Despite significant advances in therapies for HF with reduced ejection fraction (HFrEF), prognostic and clinical outcomes for HFpEF remain ominous. The paucity of research evidence supporting HFpEF therapies underscores the fundamental differences between HFpEF and HFrEF phenotypes of HF. The present review and meta-analysis summarizes the current understanding of the pathophysiology, diagnostic and therapeutic strategies to improve the current clinical management approaches.