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Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
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Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction

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[Heart failure with preserved ejection fraction]

Jindřich Špinar, Jiří Vítovec, Lenka Špinarová

    Vnitrni Lekarstvi
    |September 15, 2016
    PubMed

    Insights

    Heart failure with preserved ejection fraction (HFpEF) is common and diagnosed via echocardiography and natriuretic peptides. Treatment focuses on symptom relief and managing comorbidities, though mortality reduction evidence is limited.

    Area of Science:

    • Cardiology
    • Internal Medicine
    • Clinical Research

    Background:

    • Heart failure with preserved ejection fraction (HFpEF) occurs as frequently as heart failure with reduced ejection fraction.
    • Diagnostic criteria include echocardiography (ejection fraction >50%), left atrial enlargement, left ventricular hypertrophy, and elevated natriuretic peptides (BNP >35 pg/ml, NT-proBNP >125 pg/ml).

    Purpose of the Study:

    • To outline the diagnostic criteria for HFpEF.
    • To review current treatment strategies for HFpEF, including symptom management and prognosis improvement.
    • To emphasize the importance of managing comorbid conditions in HFpEF patients.

    Main Methods:

    • Diagnosis relies on echocardiography to assess ejection fraction, left atrial size, and left ventricular hypertrophy.
    • Biomarker analysis of natriuretic peptides (BNP and NT-proBNP) aids in diagnosis.
    • Review of current therapeutic guidelines for HFpEF management.

    Main Results:

    • Ejection fraction over 50% combined with echocardiographic findings and specific natriuretic peptide levels confirms HFpEF diagnosis.
    • Treatment lacks definitive mortality reduction evidence; diuretics manage symptoms, while ACE inhibitors/sartans and beta-blockers may improve prognosis.
    • Anticoagulation for atrial fibrillation, digoxin, and hypolipidemics are considered for secondary prevention.

    Conclusions:

    • Effective HFpEF management requires addressing symptoms and improving prognosis through guideline-directed therapies.
    • Control of comorbidities like hypertension, diabetes mellitus, and ischemic heart disease is a critical treatment goal.
    • Further research is needed to establish treatments that demonstrably reduce mortality in HFpEF.
    Abstract

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