Cited by 680Heart Failure Treatment and ManagementCardiovascular Function and Risk FactorsCardiovascular and exercise physiology

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Evaluation and management of heart failure with preserved ejection fraction

Borlaug, Barry A.·2020·Nature Reviews Cardiology

DOI 10.1038/s41569-020-0363-2

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Abstract

Heart failure with preserved ejection fraction (HFpEF) has grown to become the dominant form of heart failure worldwide, in tandem with ageing of the general population and the increasing prevalences of obesity, diabetes mellitus and hypertension. The clinical syndrome of HFpEF is heterogeneous and must be distinguished from heart failure with reduced ejection fraction as well as other aetiologies that have different treatment strategies. The diagnosis of HFpEF is challenging and ultimately relates to the conceptual definition of heart failure as a clinical syndrome characterized by symptoms that are associated with a reduced capacity of the heart to pump blood adequately at normal filling pressures during diastole. Clinical trials to date have been largely unsuccessful in identifying effective treatments for HFpEF but evidence supports the use of diuretics, mineralocorticoid antagonists and lifestyle interventions. Pathophysiological heterogeneity in the presentation of HFpEF is substantial, and ongoing studies are underway to evaluate the optimal methods to classify patients into phenotypically homogeneous subpopulations to facilitate better individualization of treatment.

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Additional file 3 of Therapeutic effects on the development of heart failure with preserved ejection fraction by the sodium-glucose cotransporter 2 inhibitor dapagliflozin in type 2 diabetes
Feng, B., Yu, P., Yu, H., Qian, B., Li, Y., Sun, K., 施毕旻, Zhang, N., & Xu, G. (2024) · Figshare · doi:10.6084/m9.figshare.26600623
Additional file 6 of Inhibition of ferroptosis reverses heart failure with preserved ejection fraction in mice
Xiong, Y., Liu, X., Jiang, L., Hao, T., Wang, Y., & Li, T. (2024) · Figshare · doi:10.6084/m9.figshare.26685291
Additional file 7 of Therapeutic effects on the development of heart failure with preserved ejection fraction by the sodium-glucose cotransporter 2 inhibitor dapagliflozin in type 2 diabetes
Feng, B., Yu, P., Yu, H., Qian, B., Li, Y., Sun, K., 施毕旻, Zhang, N., & Xu, G. (2024) · Figshare · doi:10.6084/m9.figshare.26600635
Additional file 1 of Therapeutic effects on the development of heart failure with preserved ejection fraction by the sodium-glucose cotransporter 2 inhibitor dapagliflozin in type 2 diabetes
Feng, B., Yu, P., Yu, H., Qian, B., Li, Y., Sun, K., 施毕旻, Zhang, N., & Xu, G. (2024) · Figshare · doi:10.6084/m9.figshare.26600617
Additional file 1 of Inhibition of ferroptosis reverses heart failure with preserved ejection fraction in mice
Xiong, Y., Liu, X., Jiang, L., Hao, T., Wang, Y., & Li, T. (2024) · Figshare · doi:10.6084/m9.figshare.26685276
Additional file 4 of Therapeutic effects on the development of heart failure with preserved ejection fraction by the sodium-glucose cotransporter 2 inhibitor dapagliflozin in type 2 diabetes
Feng, B., Yu, P., Yu, H., Qian, B., Li, Y., Sun, K., 施毕旻, Zhang, N., & Xu, G. (2024) · Figshare · doi:10.6084/m9.figshare.26600626
Additional file 8 of Inhibition of ferroptosis reverses heart failure with preserved ejection fraction in mice
Xiong, Y., Liu, X., Jiang, L., Hao, T., Wang, Y., & Li, T. (2024) · Figshare · doi:10.6084/m9.figshare.26685297
Additional file 1 of High triglyceride-glucose (TyG) index is associated with poor prognosis of heart failure with preserved ejection fraction
Zhou, Q., Yang, J., Tang, H., Guo, Z., Dong, W., Wang, Y., Meng, X., Zhang, K., Wang, W., Shao, C., et al. (2023) · Figshare · doi:10.6084/m9.figshare.24223723
Additional file 9 of Inhibition of ferroptosis reverses heart failure with preserved ejection fraction in mice
Xiong, Y., Liu, X., Jiang, L., Hao, T., Wang, Y., & Li, T. (2024) · Figshare · doi:10.6084/m9.figshare.26685300
Additional file 3 of Effect of sacubitril/valsartan and ACEI/ARB on glycaemia and the development of diabetes: a systematic review and meta-analysis of randomised controlled trials
Wang, R., Ye, H., Zhao, Y., Wei, J., Wang, Y., Zhang, X., & Wang, L. (2024) · Figshare · doi:10.6084/m9.figshare.26555381
Additional file 1 of Sodium-glucose co-transporter 2 inhibitors in heart failure with mildly reduced or preserved ejection fraction: an updated systematic review and meta-analysis
Wang, Y., Gao, T., Meng, C., Li, S., Bi, L., Geng, Y., & Zhang, P. (2023) · Figshare · doi:10.6084/m9.figshare.22613935
Additional file 3 of Inhibition of ferroptosis reverses heart failure with preserved ejection fraction in mice
Xiong, Y., Liu, X., Jiang, L., Hao, T., Wang, Y., & Li, T. (2024) · Figshare · doi:10.6084/m9.figshare.26685282
Additional file 5 of Therapeutic effects on the development of heart failure with preserved ejection fraction by the sodium-glucose cotransporter 2 inhibitor dapagliflozin in type 2 diabetes
Feng, B., Yu, P., Yu, H., Qian, B., Li, Y., Sun, K., 施毕旻, Zhang, N., & Xu, G. (2024) · Figshare · doi:10.6084/m9.figshare.26600629
Additional file 2 of Identification of heart failure with preserved ejection fraction helps risk stratification for hypertrophic cardiomyopathy
Liu, J., Wang, D., Ruan, J., Wu, G., Xu, L., Jiang, W., Wang, J., Xiaolu, S., 康连鸣, & Song, L. (2022) · Figshare · doi:10.6084/m9.figshare.19070025
Additional file 2 of Inhibition of ferroptosis reverses heart failure with preserved ejection fraction in mice
Xiong, Y., Liu, X., Jiang, L., Hao, T., Wang, Y., & Li, T. (2024) · Figshare · doi:10.6084/m9.figshare.26685279
Additional file 4 of Inhibition of ferroptosis reverses heart failure with preserved ejection fraction in mice
Xiong, Y., Liu, X., Jiang, L., Hao, T., Wang, Y., & Li, T. (2024) · Figshare · doi:10.6084/m9.figshare.26685285
Additional file 4 of Effect of sacubitril/valsartan and ACEI/ARB on glycaemia and the development of diabetes: a systematic review and meta-analysis of randomised controlled trials
Wang, R., Ye, H., Zhao, Y., Wei, J., Wang, Y., Zhang, X., & Wang, L. (2024) · Figshare · doi:10.6084/m9.figshare.26555384
Additional file 1 of Pharmacological mechanisms of sodium-glucose co-transporter 2 inhibitors in heart failure with preserved ejection fraction
Liang, B., Liang, Y., & Gu, N. (2022) · Figshare · doi:10.6084/m9.figshare.20056230
Additional file 1 of Vibrational spectroscopy identifies myocardial chemical modifications in heart failure with preserved ejection fraction
Pioppi, L., Parvan, R., Samrend, A., da Silva, G. J. J., Paolantoni, M., Sassi, P., & Cataliotti, A. (2024) · Figshare · doi:10.6084/m9.figshare.26616682

Authors: Borlaug, B. A.
Affiliations: Mayo Clinic (US)
Corresponding author: Borlaug, Barry A.
ORCID: Borlaug, Barry A.
Venue: Nature Reviews Cardiology
Publisher: Springer Science and Business Media LLC
Published: 2020-03-30
Volume: 17
Issue: 9
Pages: 559-573
ISSN: 1759-5002 (ISSN-L)
1759-5010
DOI: 10.1038/s41569-020-0363-2
OpenAlex: W3013711965
Cited by: 675
References: 180
Citations by year: 2026: 97 · 2025: 104 · 2024: 130 · 2023: 132 · 2022: 120 · 2021: 71 · 2020: 19
FWCI: 14.59
Type: journal article
Language: en
Open access: closed
Licence: www.springer.com/tdm (tdm)
www.springer.com/tdm (vor)
Locations: Nature Reviews Cardiology (publishedVersion)
PubMed (publishedVersion)
Funders: National Heart, Lung, and Blood Institute (R01HL128526, U01HL125205)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
Keywords: heart failure with preserved ejection fraction, HFpEF diagnosis, diuretics, mineralocorticoid receptor antagonists, lifestyle intervention, phenotypic subgroups, personalized treatment, diastolic dysfunction, aging, obesity, diabetes mellitus, hypertension
MeSH terms: Heart Failure, Humans, Middle Aged, Stroke Volume

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Evaluation and management of heart failure with preserved ejection fraction

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