Therapy for heart failure with preserved ejection fraction: current status, unique challenges, and future directions.

Journal Article (Journal Article;Review)

Heart failure (HF) with preserved ejection fraction (HFpEF) is the most common form of HF. Among elderly women, HFpEF comprises more than 80% of incident HF cases. Adverse outcomes-exercise intolerance, poor quality of life, frequent hospitalizations, and reduced survival-approach those of classic HF with reduced EF (HFrEF). However, despite its importance, our understanding of the pathophysiology of HFpEF is incomplete, and despite intensive efforts, optimal therapy remains uncertain, as most trials to date have been negative. This is in stark contrast to management of HFrEF, where dozens of positive trials have established a broad array of effective, guidelines-based therapies that definitively improve a range of clinically meaningful outcomes. In addition to providing an overview of current management status, we examine evolving data that may help explain this paradox, overcome past challenges, provide a roadmap for future success, and that underpin a wave of new trials that will test novel approaches based on these insights.

Full Text

Duke Authors

Cited Authors

  • Upadhya, B; Haykowsky, MJ; Kitzman, DW

Published Date

  • September 2018

Published In

Volume / Issue

  • 23 / 5

Start / End Page

  • 609 - 629

PubMed ID

  • 29876843

Pubmed Central ID

  • PMC7707853

Electronic International Standard Serial Number (EISSN)

  • 1573-7322

Digital Object Identifier (DOI)

  • 10.1007/s10741-018-9714-z


  • eng

Conference Location

  • United States