Heart Failure with Preserved Ejection Fraction: Mechanisms and Treatment Strategies

Approximately half of all patients with heart failure (HF) have a preserved ejection fraction, and the prevalence is growing rapidly given the aging population in many countries and the rising prevalence of obesity, diabetes, and hypertension. Functional capacity and quality of life are severely impaired in heart failure with preserved ejection fraction (HFpEF), and morbidity and mortality are high. In striking contrast to HF with reduced ejection fraction, there are few effective treatments currently identified for HFpEF, and these are limited to decongestion by diuretics, promotion of a healthy active lifestyle, and management of comorbidities. Improved phenotyping of subgroups within the overall HFpEF population might enhance individualization of treatment. This review focuses on the current understanding of the pathophysiologic mechanisms underlying HFpEF and treatment strategies for this complex syndrome.

Automated summary

The prevalence of heart failure with preserved ejection fraction (HFpEF) is increasing rapidly, and it has significant impact on the functional capacity and quality of life of patients. Unlike heart failure with reduced ejection fraction, there are limited effective treatments available for HFpEF. Therefore, improved understanding of its pathophysiologic mechanisms and individualized treatment strategies is crucial.