[Classification of heart failure and etiological approach]

Area of Science:

• Cardiology
• Internal Medicine
• Clinical Research

Background:

• Heart failure (HF) was historically considered a uniform condition.
• It is now recognized as a heterogeneous syndrome with classifications based on left ventricular ejection fraction (LVEF).
• Diagnosis and treatment are established for HF with reduced LVEF (HFrEF), but less so for HF with preserved ejection fraction (HFpEF).

Purpose of the Study:

• To highlight the heterogeneity of heart failure.
• To emphasize the diagnostic and therapeutic challenges in HFpEF.
• To underscore the importance of identifying etiologies for HFpEF to guide targeted treatments.

Main Methods:

• Review and synthesis of current understanding of heart failure classification.
• Analysis of diagnostic and treatment strategies for different HF phenotypes.
• Discussion of emerging diagnostic scores and algorithms for HFpEF management.

Main Results:

• Heart failure is classified into distinct forms based on LVEF.
• HFpEF constitutes a significant proportion of heart failure cases (up to 50%).
• Effective strategies for HFpEF diagnosis and treatment are still evolving.

Conclusions:

• Accurate classification of heart failure is essential.
• Identifying the underlying causes of HFpEF is a critical step for effective management.
• Targeted therapies, such as those for cardiac amyloidosis, can be initiated upon etiological diagnosis in HFpEF.