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Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
Published on: February 13, 2021
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[Heart failure with preserved ejection fraction (HFpEF). What's up?]
R Trokart1, J Tridetti2, M Melissopoulou2
1Service de Cardiologie, CHU Liège, Belgique.
Revue Medicale De Liege
|October 13, 2022
Summary
Heart failure with preserved ejection fraction (HFpEF) is rising. Empagliflozin shows promise in reducing mortality and hospitalizations, potentially changing future HFpEF management strategies.
Area of Science:
- Cardiology
- Internal Medicine
- Pharmacology
Background:
- Increasing prevalence of heart failure with preserved left ventricular ejection fraction (HFpEF) linked to aging and comorbidities.
- Diagnostic challenges in HFpEF, with proposed score-based algorithms from European (ESC) and American (ACC/AHA) societies.
- Current HFpEF management relies on symptomatic treatment and comorbidity management, with a historically poor prognosis.
Purpose of the Study:
- To review the current landscape of heart failure with preserved left ventricular ejection fraction (HFpEF).
- To discuss diagnostic challenges and current management strategies for HFpEF.
- To highlight emerging therapeutic options, including SGLT2 inhibitors, for HFpEF.
Main Methods:
- Review of current clinical guidelines and landmark studies in HFpEF.
- Analysis of diagnostic algorithms (ESC HFA-PEFF score, ACC/AHA H2FpEF score).
- Evaluation of recent therapeutic trial data, specifically the EMPEROR-Preserved study.
Main Results:
- No single treatment has proven effective across all HFpEF phenotypes until recently.
- The EMPEROR-Preserved study demonstrated empagliflozin (SGLT2 inhibitor) significantly reduces mortality and cardiac hospitalizations in HFpEF.
- Empagliflozin's efficacy was observed irrespective of left ventricular ejection fraction, offering a new therapeutic avenue.
Conclusions:
- HFpEF management is evolving, moving beyond symptomatic relief and comorbidity treatment.
- SGLT2 inhibitors, like empagliflozin, represent a significant advancement in HFpEF treatment.
- Future HFpEF therapies are expected to be more phenotype-specific due to the condition's heterogeneity.
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