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Evolution of a Geriatric Syndrome: Pathophysiology and Treatment of Heart Failure with Preserved Ejection Fraction.

Publication ,  Journal Article
Upadhya, B; Pisani, B; Kitzman, DW
Published in: J Am Geriatr Soc
November 2017

The majority of older adults who develop heart failure (HF), particularly older women, have a preserved left ventricular ejection fraction (HFpEF). The prevalence of this syndrome is increasing, and the prognosis is not improving, unlike that of HF with reduced ejection fraction (HFrEF). Individuals with HFpEF have severe symptoms of effort intolerance, poor quality of life, frequent hospitalizations, and greater likelihood of death. Despite the importance of HFpEF, there are numerous major gaps in our understanding of its pathophysiology and management. Although it was originally viewed as a disorder due solely to abnormalities in left ventricular diastolic function, our understanding has evolved such that HFpEF is now understood as a systemic syndrome involving multiple organ systems, and it is likely that it is triggered by inflammation and other as-yet-unidentified circulating factors, with important contributions of aging and multiple comorbidities, features generally typical of other geriatric syndromes. We present an update on the pathophysiology, diagnosis, management, and future directions in this disorder in older persons.

Duke Scholars

Published In

J Am Geriatr Soc

DOI

EISSN

1532-5415

Publication Date

November 2017

Volume

65

Issue

11

Start / End Page

2431 / 2440

Location

United States

Related Subject Headings

  • Ventricular Function, Left
  • Ventricular Dysfunction, Left
  • Stroke Volume
  • Quality of Life
  • Prognosis
  • Male
  • Humans
  • Heart Ventricles
  • Heart Failure
  • Geriatrics
 

Citation

APA
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ICMJE
MLA
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Upadhya, B., Pisani, B., & Kitzman, D. W. (2017). Evolution of a Geriatric Syndrome: Pathophysiology and Treatment of Heart Failure with Preserved Ejection Fraction. J Am Geriatr Soc, 65(11), 2431–2440. https://doi.org/10.1111/jgs.15141
Upadhya, Bharathi, Barbara Pisani, and Dalane W. Kitzman. “Evolution of a Geriatric Syndrome: Pathophysiology and Treatment of Heart Failure with Preserved Ejection Fraction.J Am Geriatr Soc 65, no. 11 (November 2017): 2431–40. https://doi.org/10.1111/jgs.15141.
Upadhya B, Pisani B, Kitzman DW. Evolution of a Geriatric Syndrome: Pathophysiology and Treatment of Heart Failure with Preserved Ejection Fraction. J Am Geriatr Soc. 2017 Nov;65(11):2431–40.
Upadhya, Bharathi, et al. “Evolution of a Geriatric Syndrome: Pathophysiology and Treatment of Heart Failure with Preserved Ejection Fraction.J Am Geriatr Soc, vol. 65, no. 11, Nov. 2017, pp. 2431–40. Pubmed, doi:10.1111/jgs.15141.
Upadhya B, Pisani B, Kitzman DW. Evolution of a Geriatric Syndrome: Pathophysiology and Treatment of Heart Failure with Preserved Ejection Fraction. J Am Geriatr Soc. 2017 Nov;65(11):2431–2440.
Journal cover image

Published In

J Am Geriatr Soc

DOI

EISSN

1532-5415

Publication Date

November 2017

Volume

65

Issue

11

Start / End Page

2431 / 2440

Location

United States

Related Subject Headings

  • Ventricular Function, Left
  • Ventricular Dysfunction, Left
  • Stroke Volume
  • Quality of Life
  • Prognosis
  • Male
  • Humans
  • Heart Ventricles
  • Heart Failure
  • Geriatrics