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Current therapeutic approach in heart failure with preserved ejection fraction
Jose Nativi-Nicolau1, John J Ryan2, James C Fang1
1Division of Cardiovascular Medicine, Department of Medicine, University of Utah Health Science Center, 50 N Medical Dr, Salt Lake City, UT 84132, USA; Cardiology Section, Veterans Affairs Salt Lake City Health Care System, 500 Foothill Dr, Salt Lake City, UT 84148, USA.
Heart Failure Clinics
|July 1, 2014
Summary
Heart failure with preserved ejection fraction (HFpEF) management focuses on symptom relief and risk factors. Current therapies offer symptomatic benefits but lack clear improvements in major clinical outcomes for HFpEF patients.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- Heart failure with preserved ejection fraction (HFpEF) is a complex syndrome.
- It involves reduced exercise capacity and fluid retention despite normal left ventricular systolic function.
- Abnormal diastolic function is a key characteristic of HFpEF.
Purpose of the Study:
- To review current therapeutic strategies for HFpEF.
- To summarize the evidence base for potential new therapeutic targets.
- To inform clinical management and future research directions.
Main Methods:
- Literature review of existing clinical trials and therapeutic approaches.
- Analysis of pharmacologic agents, pacing, baroreflex modification, diet, and exercise interventions.
- Evaluation of evidence for symptomatic and outcome improvements.
Main Results:
- Various therapeutic strategies show symptomatic and hemodynamic improvements.
- Large clinical trials have not consistently demonstrated significant improvements in major clinical outcomes.
- Current management emphasizes diuretics for congestion and risk factor modification.
Conclusions:
- Despite symptomatic benefits, effective treatments targeting clinical outcomes in HFpEF remain limited.
- Further research is needed to identify and validate novel therapeutic targets.
- Optimizing current management involves symptom control and addressing underlying risk factors.
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