Heart failure with preserved ejection fraction based on aging and comorbidities.

Area of Science:

• Cardiology
• Geriatrics
• Internal Medicine

Background:

• Heart failure with preserved ejection fraction (HFpEF) significantly impacts older adults (≥65 years), leading to hospitalizations and mortality.
• HFpEF is a complex, multisystemic syndrome with varied pathophysiology and phenotypes, challenging traditional diagnosis based solely on ejection fraction.
• Existing HF treatments are ineffective for HFpEF, highlighting a critical unmet need.

Purpose of the Study:

• To review the current diagnostic and therapeutic landscape of HFpEF.
• To examine the intricate interplay between aging, comorbidities, and HFpEF.
• To emphasize the need for tailored approaches in HFpEF management.

Main Methods:

• Literature review focusing on diagnostic criteria and therapeutic strategies for HFpEF.
• Analysis of studies investigating the influence of aging and common comorbidities on HFpEF.
• Synthesis of findings related to HFpEF phenotyping and subgroup analysis.

Main Results:

• Diagnosis of HFpEF is challenging and may require individualized assessment beyond ejection fraction.
• Aging and comorbidities significantly complicate HFpEF, influencing its presentation and response to treatment.
• Current HF medications have shown limited efficacy in improving HFpEF outcomes.

Conclusions:

• Understanding the biology, diagnosis, and treatment of HFpEF requires further research into its relationship with aging and comorbidities.
• Phenotyping HFpEF patients is crucial for developing effective, personalized treatment strategies.
• Addressing the complexities of aging and comorbidities is essential for advancing HFpEF care.