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Current Treatment of Heart Failure with Preserved Ejection Fraction
Mauro Riccardi1,2, Emilia D'Elia3, Carlo M Lombardi1,2
1Institute of Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25121 Brescia, Italy.
Journal of Clinical Medicine
|August 14, 2025
Summary
New pharmacotherapies, including SGLT2 inhibitors and MRAs, are transforming heart failure with preserved ejection fraction (HFpEF) management. Early, personalized treatment strategies are key for improved outcomes in HFpEF patients.
Area of Science:
- Cardiology
- Pharmacology
- Internal Medicine
Background:
- Heart failure with preserved ejection fraction (HFpEF) is a complex condition with rising prevalence and significant health impacts.
- Current management of HFpEF is evolving due to recent therapeutic advancements.
Purpose of the Study:
- To review the latest evidence for pharmacotherapies in HFpEF management.
- To highlight personalized and comorbidity-targeted treatment strategies for HFpEF.
Main Methods:
- Literature review of current evidence on key drug classes for HFpEF.
- Analysis of treatment approaches including early initiation and phenotypic tailoring.
Main Results:
- Sodium-glucose cotransporter 2 inhibitors (SGLT2i) show promise in HFpEF.
- Non-steroidal mineralocorticoid receptor antagonists (MRAs) and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) offer therapeutic benefits.
- Angiotensin receptor-neprilysin inhibitors (ARNIs) have a selected role.
Conclusions:
- A new era of guideline-directed, personalized care for HFpEF is emerging.
- Early intervention with disease-modifying therapies is crucial.
- Tailoring treatment to patient phenotypes and comorbidities, particularly obesity and diabetes, improves outcomes.
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