Patient phenotype profiling in heart failure with preserved ejection fraction to guide therapeutic decision making. A scientific statement of the Heart Failure Association and the European Heart Rhythm Association of the European Society of Cardiology, and the European Society of Hypertension

Heart failure with preserved ejection fraction (HFpEF) represents a highly heterogeneous clinical syndrome affected in its development and progression by many comorbidities. The left ventricular diastolic dysfunction may be a manifestation of various combinations of cardiovascular, metabolic, pulmonary, renal, and geriatric conditions. Thus, in addition to treatment with sodium-glucose cotransporter 2 inhibitors in all patients, the most effective method of improving clinical outcomes may be therapy tailored to each patient's clinical profile. To better outline a phenotype-based approach for the treatment of HFpEF, in this joint position paper, the Heart Failure Association of the European Society of Cardiology, the European Heart Rhythm Association and the European Hypertension Society, have developed an algorithm to identify the most common HFpEF phenotypes and identify the evidence-based treatment strategy for each, while taking into account the complexities of multiple comorbidities and polypharmacy.

Automated summary

HFpEF is a highly heterogeneous clinical syndrome influenced by many comorbidities in its development and progression. Left ventricular diastolic dysfunction may result from various cardiovascular, metabolic, pulmonary, renal, and geriatric conditions. Therefore, individualized treatment tailored to each patient's clinical profile may be the most effective approach to improve clinical outcomes. In this joint position paper, the Heart Failure Association of the European Society of Cardiology, the European Heart Rhythm Association, and the European Hypertension Society have developed an algorithm to identify the most common HFpEF phenotypes and recommend evidence-based treatment strategies for each, considering the complexities of multiple comorbidities and polypharmacy.