Therapy for heart failure with preserved ejection fraction: current status, unique challenges, and future directions

Therapy for heart failure with preserved ejection fraction: current status, unique challenges,... Heart failure (HF) with preserved ejection fraction (HFpEF) is the most common form of HF. Among elderly women, HFpEF comprises more than 80% of incident HF cases. Adverse outcomes—exercise intolerance, poor quality of life, frequent hospitalizations, and reduced survival—approach those of classic HF with reduced EF (HFrEF). However, despite its importance, our understanding of the pathophysiology of HFpEF is incomplete, and despite intensive efforts, optimal therapy remains uncertain, as most trials to date have been negative. This is in stark contrast to management of HFrEF, where dozens of positive trials have established a broad array of effective, guidelines-based therapies that definitively improve a range of clinically meaningful outcomes. In addition to providing an overview of current management status, we examine evolving data that may help explain this paradox, overcome past challenges, provide a roadmap for future success, and that underpin a wave of new trials that will test novel approaches based on these insights. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Heart Failure Reviews Springer Journals

Therapy for heart failure with preserved ejection fraction: current status, unique challenges, and future directions

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Publisher
Springer Journals
Copyright
Copyright © 2018 by Springer Science+Business Media, LLC, part of Springer Nature
Subject
Medicine & Public Health; Cardiology
ISSN
1382-4147
eISSN
1573-7322
D.O.I.
10.1007/s10741-018-9714-z
Publisher site
See Article on Publisher Site

Abstract

Heart failure (HF) with preserved ejection fraction (HFpEF) is the most common form of HF. Among elderly women, HFpEF comprises more than 80% of incident HF cases. Adverse outcomes—exercise intolerance, poor quality of life, frequent hospitalizations, and reduced survival—approach those of classic HF with reduced EF (HFrEF). However, despite its importance, our understanding of the pathophysiology of HFpEF is incomplete, and despite intensive efforts, optimal therapy remains uncertain, as most trials to date have been negative. This is in stark contrast to management of HFrEF, where dozens of positive trials have established a broad array of effective, guidelines-based therapies that definitively improve a range of clinically meaningful outcomes. In addition to providing an overview of current management status, we examine evolving data that may help explain this paradox, overcome past challenges, provide a roadmap for future success, and that underpin a wave of new trials that will test novel approaches based on these insights.

Journal

Heart Failure ReviewsSpringer Journals

Published: Jun 7, 2018

References

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