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[Diagnosis and therapy of heart failure with normal ejection fraction]

Hans-Hendrik Schaefer1, Thomas Dieterle

  • 1Medical Department, Novartis Pharma Schweiz AG, Bern.

Therapeutische Umschau. Revue Therapeutique
|January 29, 2011
PubMed

Insights

Diastolic heart failure, or heart failure with preserved ejection fraction (HFpEF), is common and deadly. Current treatments focus on managing risk factors and ischemia, as no therapy has proven to reduce mortality.

Area of Science:

  • Cardiology
  • Heart Failure Research
  • Clinical Medicine

Context:

  • Diastolic heart failure (HFpEF) presents with heart failure symptoms but normal or preserved ejection fraction.
  • High global prevalence and mortality rates underscore the significance of HFpEF.
  • Etiology involves cardiomyocyte, extracellular matrix, and vascular abnormalities, though incompletely understood.

Purpose:

  • To define the characteristics, diagnosis, and current therapeutic limitations of diastolic heart failure.
  • To highlight the diagnostic criteria including symptoms, elevated natriuretic peptides, and impaired diastolic function.
  • To emphasize the need for effective treatments for HFpEF.

Summary:

  • Diastolic heart failure (HFpEF) is characterized by heart failure symptoms with normal or preserved left ventricular ejection fraction.
  • Diagnosis requires clinical signs, elevated natriuretic peptides, impaired diastolic function, and normal systolic function, confirmed by catheterization or MRI.
  • No therapy has definitively reduced HFpEF morbidity and mortality; management focuses on risk factors and ischemia.

Impact:

  • Informs clinical practice regarding HFpEF diagnosis and current management strategies.
  • Highlights the urgent need for novel therapeutic approaches to reduce HFpEF mortality.
  • Guides future research directions for understanding and treating diastolic heart failure.

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