[Heart failure with preserved ejection fraction]

Heart failure with preserved ejection fraction (HFPEF) is defined by the combination of clinical symptoms or signs of heart failure and an ejection fraction> or =50+/-5%. HFPEF accounts for nearly 50% of cases of heart failure, and its prevalence is increasing as the population ages. It is seen most often as acute rapid-onset or flash pulmonary edema, in a patient with no or few symptoms except for these acute episodes, often associated with a precipitating factor. Diagnosis of HFPEF is facilitated by the development of plasma assays of natriuretic peptides and of Doppler echocardiography. Its causes, which must be identified, are mainly hypertensive, diabetic or ischemic cardiomyopathy, often combined. Its prognosis is similar to that of systolic heart failure and leads to frequent hospitalization for acute decompensation. Its treatment calls for the same therapeutic arsenal as for systolic heart failure, except among patients with diabetes.