Diagnosis and treatment of heart failure with preserved left ventricular ejection fraction

Area of Science:

• Cardiology
• Internal Medicine

Background:

• Heart failure affects nearly six million Americans.
• Fifty percent of heart failure patients exhibit preserved left ventricular (LV) systolic function but impaired diastolic function due to increased LV myocardial stiffness.
• This condition commonly affects elderly women with hypertension, ischemic heart disease, atrial fibrillation, obesity, diabetes mellitus, renal disease, or obstructive lung disease.

Purpose of the Study:

• To summarize the characteristics, diagnosis, and management of heart failure with preserved ejection fraction (HFpEF).

Main Methods:

• Diagnosis relies on patient history, physical examination, laboratory data, echocardiography, and cardiac catheterization when necessary.
• Management strategies include weight reduction, exercise programs, aggressive control of blood pressure and heart rate, and diuretics for patients with obesity, hypertension, atrial fibrillation, and volume overload.
• Pulmonary artery pressure monitoring devices offer early warnings of pulmonary hypertension and congestion. Coronary revascularization is considered for significant coronary heart disease.

Main Results:

• The annual mortality rate for these patients ranges from 8% to 12% per year.
• Effective management involves addressing multiple risk factors and utilizing advanced monitoring technologies.
• Surgical intervention for coronary heart disease can be beneficial.

Conclusions:

• Heart failure with preserved ejection fraction (HFpEF) is a significant clinical problem with high mortality.
• Comprehensive management addressing comorbidities and utilizing monitoring devices is essential.
• Coronary revascularization should be considered in appropriate patients.