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Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
Published on: February 13, 2021
Heart failure with normal left ventricular ejection fraction: what is the evidence?
Michael Kindermann1, Jan-Christian Reil, Burkert Pieske
1Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany. michael.kindermann@t-online.de
Trends in Cardiovascular Medicine
|April 7, 2009
Summary
Heart failure with normal ejection fraction (HFNEF) involves diastolic dysfunction and arterial stiffening. Current treatments focus on symptom management, as mortality-reducing drugs are scarce for HFNEF.
Area of Science:
- Cardiology
- Internal Medicine
- Pathophysiology
Background:
- Heart failure with normal ejection fraction (HFNEF) presents diagnostic and therapeutic challenges.
- HFNEF is characterized by diastolic left ventricular (LV) dysfunction and increased ventricular and arterial stiffness.
- Current guidelines define HFNEF by heart failure symptoms with preserved LV ejection fraction (>50%) and evidence of diastolic dysfunction.
Purpose of the Study:
- To review the pathophysiology, diagnosis, and treatment of HFNEF.
- To highlight the diagnostic role of echocardiography and natriuretic peptides.
- To discuss current therapeutic strategies and the limitations of clinical trials in HFNEF.
Main Methods:
- Review of current literature and clinical guidelines on HFNEF.
- Discussion of diagnostic criteria including echocardiography (E/E' ratio) and plasma natriuretic peptides.
- Analysis of treatment approaches focusing on symptom management and pathophysiological targets.
Main Results:
- HFNEF pathophysiology involves diastolic dysfunction and arterial stiffening.
- Echocardiography (E/E') and natriuretic peptides aid in diagnosing HFNEF.
- Treatment is symptom-oriented; large trials demonstrating mortality reduction are lacking.
Conclusions:
- HFNEF remains a complex condition requiring further research into its pathophysiology and effective therapies.
- Accurate diagnosis relies on excluding other conditions and utilizing advanced echocardiographic parameters.
- Current treatment strategies for HFNEF are primarily supportive, with limited evidence for mortality benefit from specific drugs.
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