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Updated: May 4, 2026

Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
Published on: February 13, 2021
Management of Patient With Tricuspid Regurgitation and Heart Failure With Preserved Ejection Fraction
Joanna Bartkowiak1, Vratika Agarwal1, Diana Otero2
1Department of Medicine, The New York-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA.
Background:
Heart failure with preserved ejection fraction (HFpEF) and tricuspid regurgitation are increasingly recognized as interrelated conditions with overlapping management approaches.
Case Summary:
A 69-year-old woman presented with worsening palpitations and exertional dyspnea. Her symptoms, in combination with a preserved ejection fraction and evidence of increased left ventricular filling pressures, were indicative of HFpEF. Echocardiographic examination revealed torrential tricuspid regurgitation. Guideline-directed medical therapy was optimized, resulting in improvement of tricuspid regurgitation severity.
Discussion:
Recent guidelines for HFpEF management emphasize the use of diuretics for symptom control and the addition of sodium-glucose cotransporter 2 inhibitors and sacubitril-valsartan to improve outcomes. The case underscores the importance of addressing the underlying hemodynamic contributors to tricuspid regurgitation before considering surgical or catheter-based interventions.
Take-Home Messages:
Guideline-directed medical therapy for HFpEF plays a crucial role in symptom relief, improves outcomes, and may help reduce tricuspid regurgitation severity.
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