Current Heart Failure Reports

, Volume 10, Issue 4, pp 341–349

Ventricular Remodeling in Heart Failure with Preserved Ejection Fraction

Pathophysiology of Myocardial Failure (IS Anand and M Sarraf, Section Editors)

DOI: 10.1007/s11897-013-0166-4

Cite this article as:
Shah, A.M. Curr Heart Fail Rep (2013) 10: 341. doi:10.1007/s11897-013-0166-4

Abstract

Heart failure with preserved ejection fraction (HFpEF) is common, increasing in prevalence, and causes substantial morbidity and mortality. HFpEF has commonly been viewed as an expression of advanced hypertensive heart disease, with a cardiac phenotype characterized by an increase in wall thickness-to-chamber radius ratio (concentric hypertrophy). However, marked clinical heterogeneity within this syndrome is now well appreciated, and is mirrored in the variability in left ventricular (LV) structure. A review of larger imaging studies from epidemiology and clinical trial cohorts demonstrate that while concentric LV remodeling is common, it is by no means universal and many patients demonstrate normal LV geometry or even an eccentric pattern. More detailed assessment of cardiac structure and function in broader HFpEF populations will be necessary to better define the prevalence, determinants, and prognostic relevance of these measures, which may in turn serve as a foundation to identify pathophysiologically relevant sub-phenotypes within this diverse syndrome.

Keywords

Heart failurePreserved Ejection FractionVentricular RemodelingEchocardiography

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Division of Cardiovascular MedicineBrigham and Women’s HospitalBostonUSA