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A Surgical Model of Heart Failure with Preserved Ejection Fraction in Tibetan Minipigs
Published on: February 18, 2022
[Diagnosis and treatment of heart failure with preserved ejection fraction]
Samira Soltani, Johann Bauersachs1
1Klinik für Kardiologie und Angiologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland. bauersachs.johann@mh-hannover.de.
Insights
New treatments like SGLT2 inhibitors and GLP-1 analogs are improving prognosis for heart failure with preserved ejection fraction (HFpEF). Finerenone and valve interventions also show promise for HFpEF patients.
Area of Science:
- Cardiology
- Pharmacology
Abstract:
The treatment of heart failure with preserved ejection fraction (HFpEF) involves symptomatic management of congestion with diuretics (class I recommendation) and treatment with sodium-glucose linked transporter 2 (SGLT2) inhibitors for improvement of the prognosis, which have a class I recommendation across the entire spectrum of left ventricular ejection fraction (LVEF) in the current guidelines. The data supporting the recommendation of SGLT2 inhibitors in HFpEF come from the EMPEROR-Preserved and DELIVER studies. The FINEARTS-HF study showed positive effects on cardiovascular death/heart failure hospitalization of the treatment of HFpEF patients with finerenone, a nonsteroidal mineralocorticoid receptor antagonist. The STEP-HFpEF (2023) and SUMMIT (2024) studies investigated the treatment with glucagon-like peptide 1 (GLP-1) analogs in patients with HFpEF and obesity and showed positive outcomes regarding quality of life and, in the latter study, positive effects on heart failure events. The treatment of severe mitral and tricuspid valve regurgitation impacts not only the symptom burden but also hospitalization and overall prognosis in HFpEF patients.
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