TY - JOUR
T1 - A Stepwise Guide to the Diagnosis and Treatment of Heart Failure With Preserved Ejection Fraction
AU - Vaishnav, JOBAN
AU - Sharma, Kavita
N1 - Funding Information:
Graphics support for tables was provided by Kelly Jeng, PhD, of ApotheCom (Yardley, PA, USA) and was funded by Novartis Pharmaceuticals Corporation. This manuscript was developed in accordance with Good Publication Practice (GPP3) guidelines. The authors had full control of the content and made the final decision on all aspects of this publication.
Publisher Copyright:
© 2021
PY - 2022/6
Y1 - 2022/6
N2 - Heart failure with preserved ejection fraction (HFpEF) is a growing epidemic owing to an increasingly obese and aging patient population. Making the diagnosis of HFpEF is often challenging because patients frequently have multiple comorbidities and alternative reasons for dyspnea and exercise intolerance, symptoms that are hallmark to the disease. Additionally, a universal diagnostic algorithm and definition of HFpEF is lacking. The treatment of HFpEF has been equally challenging, as there remain exceedingly few therapies show to improve survival in HFpEF and thus management to date has focused on intensive optimization of HFpEF risk factors. In this review, we highlight a stepwise approach to the diagnosis and treatment of HFpEF including (1) how to establish a clinical diagnosis of HFpEF, (2) when to refer for invasive diagnostic testing, (3) current treatment approaches to HFpEF including pharmacologic, nonpharmacologic, and risk factor modification interventions, and (4) when to refer to a dedicated HFpEF center or advanced heart failure specialist. With this systematic stepwise approach to HFpEF diagnosis and management, we aim to improve accurate diagnosis of the disease as well as raise awareness of available therapeutic options for this challenging patient population.
AB - Heart failure with preserved ejection fraction (HFpEF) is a growing epidemic owing to an increasingly obese and aging patient population. Making the diagnosis of HFpEF is often challenging because patients frequently have multiple comorbidities and alternative reasons for dyspnea and exercise intolerance, symptoms that are hallmark to the disease. Additionally, a universal diagnostic algorithm and definition of HFpEF is lacking. The treatment of HFpEF has been equally challenging, as there remain exceedingly few therapies show to improve survival in HFpEF and thus management to date has focused on intensive optimization of HFpEF risk factors. In this review, we highlight a stepwise approach to the diagnosis and treatment of HFpEF including (1) how to establish a clinical diagnosis of HFpEF, (2) when to refer for invasive diagnostic testing, (3) current treatment approaches to HFpEF including pharmacologic, nonpharmacologic, and risk factor modification interventions, and (4) when to refer to a dedicated HFpEF center or advanced heart failure specialist. With this systematic stepwise approach to HFpEF diagnosis and management, we aim to improve accurate diagnosis of the disease as well as raise awareness of available therapeutic options for this challenging patient population.
KW - Heart failure with preserved ejection fraction
KW - exercise stress test
KW - natriuretic peptides
UR - http://www.scopus.com/inward/record.url?scp=85125785005&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85125785005&partnerID=8YFLogxK
U2 - 10.1016/j.cardfail.2021.12.013
DO - 10.1016/j.cardfail.2021.12.013
M3 - Review article
C2 - 34968656
AN - SCOPUS:85125785005
SN - 1071-9164
VL - 28
SP - 1016
EP - 1030
JO - Journal of Cardiac Failure
JF - Journal of Cardiac Failure
IS - 6
ER -