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Current Updates in the Pharmacotherapy of Heart Failure with a Preserved Ejection Fraction

Ranjan Dahal1, Nils Nickel2, Debabrata Mukherjee1

  • 1Division of Cardiology, Department of Internal Medicine, Texas Tech University Health Sciences Center, El Paso, Texas, United States.

Cardiovascular & Hematological Disorders Drug Targets
|July 5, 2022
PubMed

Insights

Heart failure with preserved ejection fraction (HFpEF) management is evolving. New therapies like SGLT2 inhibitors show promise in reducing hospitalizations, offering hope for this growing patient population.

Area of Science:

  • Cardiology
  • Pharmacology
  • Geriatrics

Background:

  • Heart failure is a leading global cause of death, with HFpEF increasingly prevalent, especially in the elderly.
  • HFpEF accounts for approximately 50% of all heart failure cases, posing a significant and growing public health challenge.
  • The financial burden of heart failure care is substantial and projected to increase, with hospitalizations being a major cost driver.

Approach:

  • A comprehensive literature review was conducted using PubMed and Embase.
  • The review focused on examining available pharmacotherapeutics for managing HFpEF.
  • Studies investigating the reduction of heart failure hospitalizations in HFpEF patients were analyzed.

Key Points:

  • Traditional management strategies focused on comorbidities like diabetes and hypertension.
  • Several previously studied medications, including beta-blockers and ACE inhibitors, did not demonstrate efficacy in reducing HFpEF hospitalizations.
  • Recent trials like EMPEROR-PRESERVED and PARAGON-HF offer new insights into effective HFpEF pharmacotherapy.

Conclusions:

  • Empagliflozin and Dapagliflozin show promising results in HFpEF management, regardless of diabetes status.
  • Sacubitril/valsartan and Empagliflozin are currently the only approved medications for HFpEF based on PARAGON-HF and EMPEROR-PRESERVED study findings.
  • These findings represent a significant advancement in the pharmacotherapy of HFpEF, potentially improving patient outcomes and reducing healthcare costs.
Abstract

Keywords:
Heart failure with preserved ejection fraction (HFpEF)SGLT-2 inhibitorsangiotensin receptor neprilysin inhibitor (ARNI)diastolic heart failurediureticspharmacotherapy

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