Current therapeutic approach in heart failure with preserved ejection fraction

Heart Fail Clin. 2014 Jul;10(3):525-38. doi: 10.1016/j.hfc.2014.04.007.

Abstract

Heart failure with preserved ejection fraction (HFpEF) is a clinical syndrome characterized by decreased exercise capacity and fluid retention in the setting of preserved left ventricular systolic function and evidence of abnormal diastolic function. Therapeutic strategies include pharmacologic agents, pacing, baroreflex modification, diet, and exercise. Despite symptomatic and hemodynamic improvements with some therapies, large clinical trials have not demonstrated a clear improvement in clinical outcomes. The current management of patients with HFpEF is directed to symptomatic relief of congestion with diuretics and risk factor modification. In this article, we summarize the available evidence base for potential targets of therapy.

Keywords: Diastole; Heart failure; Therapy.

Publication types

  • Review

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use
  • Aged
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Cardiotonic Agents / therapeutic use*
  • Disease Management
  • Diuretics / therapeutic use*
  • Female
  • Heart Failure / diagnosis
  • Heart Failure / drug therapy*
  • Heart Failure / mortality
  • Humans
  • Life Style
  • Male
  • Middle Aged
  • Prognosis
  • Randomized Controlled Trials as Topic
  • Reference Values
  • Risk Assessment
  • Risk Reduction Behavior
  • Stroke Volume / physiology*
  • Survival Analysis
  • Syndrome
  • Treatment Outcome
  • Ventricular Function, Left / physiology*

Substances

  • Adrenergic beta-Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Cardiotonic Agents
  • Diuretics