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The Heart Failure with Preserved Ejection Fraction Conundrum—Redefining the Problem and Finding Common Ground?

  • Decompensated Heart Failure (P Banerjee, Section Editor)
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Abstract

Purpose of Review

Heart failure with preserved ejection fraction (HFpEF) or diastolic heart failure (DHF) makes up more than half of all congestive heart failure presentations (CHF). With an ageing population, the case load and the financial burden is projected to increase, even to epidemic proportions. CHF hospitalizations add too much of the financial and infrastructure strain. Unlike systolic heart failure (SHF), much is still either uncertain or unknown. Specifically, in epidemiology, the disease burden is established; however, risk factors and pathophysiological associations are less clear; diagnostic tools are based on rigid parameters without the ability to accurately monitor treatments effects and disease progression; finally, therapeutics are similar to SHF but without prognostic data for efficacy.

Recent Findings

The last several years have seen guidelines changing to account for greater epidemiological observations. Most of these remain general observation of shortness of breath symptom matched to static echocardiographic parameters. The introduction of exercise diastolic stress test has been welcome and warrants greater focus.

Summary

HFpEF is likely to see new thinking in the coming decades. This review provides some of perspective on this topic.

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Funding

All co-authors have won independent and governmental research funding.

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Authors and Affiliations

  1. Werribee Mercy Sub School, School of Medicine, Sydney, Australia

    P. Iyngkaran

  2. Biochemistry of Diabetes Complications, Melbourne, Australia

    M. C. Thomas

  3. Department of Medicine—Western Precinct, University of Melbourne, Melbourne, Victoria, 3011, Australia

    C. Neil

  4. Department of Cardiology, St. Vincent’s Hospital, Melbourne, Victoria, Australia

    M. Jelinek

  5. Department of Diabetes, The Alfred and Monash University, Melbourne, Australia

    M. Cooper

  6. Cardiology University of Adelaide, Adelaide, 5011, Australia

    J. D. Horowitz

  7. Cardiovascular Research, Heart Failure Services, Austin Health, University of Melbourne, Melbourne, Victoria, Australia

    D. L. Hare

  8. Cardiology and Head Heart Failure Research, Alfred Hospital, Melbourne, Australia

    D. M. Kaye

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  1. P. Iyngkaran
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  2. M. C. Thomas
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  3. C. Neil
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  4. M. Jelinek
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  8. D. M. Kaye
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Correspondence to D. M. Kaye.

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Iyngkaran, P., Thomas, M.C., Neil, C. et al. The Heart Failure with Preserved Ejection Fraction Conundrum—Redefining the Problem and Finding Common Ground?. Curr Heart Fail Rep 17, 34–42 (2020). https://doi.org/10.1007/s11897-020-00454-2

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