Diagnosing heart failure with preserved ejection fraction

TY - JOUR

T1 - Diagnosing heart failure with preserved ejection fraction

AU - Becher, Peter Moritz

AU - Lindner, Diana

AU - Fluschnik, Nina

AU - Blankenberg, Stefan

AU - Westermann, Dirk

PY - 2013/9

Y1 - 2013/9

N2 - INTRODUCTION: Heart failure with preserved ejection fraction (HFPEF) is a common syndrome, accounting for about 50% of all patients with heart failure (HF). Morbidity and mortality are similar to patients with HF with reduced ejection fraction (HFREF), yet no effective treatment has been identified in randomized clinical trials.AREAS COVERED: This article provides an overview of the available literature regarding diagnosing established HFPEF and potential new therapeutic targets for the early diagnosis of HFPEF. Vascular dysfunction, ventricular-arterial coupling, oxidative stress, extracellular matrix regulation, chronotropic incompetence, pulmonary hypertension, exercise testing and biomarkers were taken into consideration next to conventional measurements of diastolic dysfunction.EXPERT OPINION: Measuring diastolic dysfunction in HFPEF is considered important in many patients. Nevertheless, today we know that other causes besides diastolic dysfunction are also involved in the pathophysiology of many HFPEF patients and need to be investigated in order to make a correct diagnosis. Therefore, further research is required to allow better and more specific diagnostic and treatment options to reduce the morbidity and mortality for this ever-expanding HF population.

AB - INTRODUCTION: Heart failure with preserved ejection fraction (HFPEF) is a common syndrome, accounting for about 50% of all patients with heart failure (HF). Morbidity and mortality are similar to patients with HF with reduced ejection fraction (HFREF), yet no effective treatment has been identified in randomized clinical trials.AREAS COVERED: This article provides an overview of the available literature regarding diagnosing established HFPEF and potential new therapeutic targets for the early diagnosis of HFPEF. Vascular dysfunction, ventricular-arterial coupling, oxidative stress, extracellular matrix regulation, chronotropic incompetence, pulmonary hypertension, exercise testing and biomarkers were taken into consideration next to conventional measurements of diastolic dysfunction.EXPERT OPINION: Measuring diastolic dysfunction in HFPEF is considered important in many patients. Nevertheless, today we know that other causes besides diastolic dysfunction are also involved in the pathophysiology of many HFPEF patients and need to be investigated in order to make a correct diagnosis. Therefore, further research is required to allow better and more specific diagnostic and treatment options to reduce the morbidity and mortality for this ever-expanding HF population.

KW - Heart Failure/diagnosis

KW - Heart Function Tests

KW - Humans

KW - Stroke Volume/physiology

U2 - 10.1517/17530059.2013.825246

DO - 10.1517/17530059.2013.825246

M3 - SCORING: Review article

C2 - 23930995

VL - 7

SP - 463

EP - 474

IS - 5

ER -