[ANMCO Position paper: Management of heart failure with preserved ejection fraction]

Area of Science:

• Cardiology
• Pharmacology

Background:

• Heart failure is a primary cause of cardiovascular hospitalization, with increasing prevalence, particularly in older adults.
• Heart failure with preserved ejection fraction (HFpEF) affects approximately 50% of heart failure patients and previously lacked effective pharmacological treatments.
• HFpEF diagnosis is complicated by comorbidities, potentially leading to delayed or incorrect treatment and poor prognosis.

Purpose of the Study:

• To provide clinicians with a diagnostic and therapeutic tool for managing patients with HFpEF.
• To guide healthcare professionals toward optimal diagnostic and treatment pathways for HFpEF.
• To highlight the impact of recent pharmacological advancements on HFpEF management.

Main Methods:

• Review of recent clinical trials on gliflozin use in HFpEF patients.
• Analysis of diagnostic challenges influenced by comorbidities in HFpEF.
• Development of a clinical guidance framework for HFpEF diagnosis and treatment.

Main Results:

• Gliflozins have demonstrated effectiveness in altering the natural history of HFpEF, reducing hospitalization and mortality.
• Early and accurate diagnosis is critical for initiating effective treatment in HFpEF.
• Recognizing overlapping symptoms with rare diseases is essential for avoiding unfavorable prognoses.

Conclusions:

• Gliflozins represent a significant therapeutic advancement for HFpEF.
• A structured approach to diagnosis and treatment is vital for improving HFpEF patient outcomes.
• This position paper serves as a practical guide for clinicians managing HFpEF.