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Heart failure with preserved ejection fraction (HFpEF): Implications for the anesthesiologists
1Department of Cardiac Anesthesia, Institute of Critical Care and Anesthesiology, Medanta-The Medicity, Gurgaon, Haryana, India.
Journal of Anaesthesiology, Clinical Pharmacology
|August 15, 2018
Summary
Heart failure with preserved ejection fraction (HFpEF) affects older women with comorbidities. Management focuses on hemodynamic stability and treating underlying conditions, as specific HFpEF treatments are not established.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- Heart failure (HF) is a clinical syndrome due to impaired ventricular function.
- Guidelines classify HF into HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF).
- HFpEF is characterized by diastolic dysfunction.
Purpose of the Study:
- To review the characteristics, diagnosis, and management of HFpEF.
- To highlight the specific considerations for patients with HFpEF, particularly in the perioperative setting.
Main Methods:
- Review of current guidelines and literature on HFpEF.
- Identification of risk factors, diagnostic tools, and therapeutic strategies for HFpEF.
Main Results:
- HFpEF risk factors include advanced age, female gender, hypertension, diabetes, and renal insufficiency.
- Diagnosis is confirmed via cardiac catheterization and echocardiography.
- Intraoperative goals include avoiding tachycardia, maintaining sinus rhythm, and adequate filling pressures.
Conclusions:
- No specific treatment for HFpEF is currently established.
- Management involves diuretics, beta-blockers, calcium channel blockers, venodilators, and comorbidity management.
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