Cargando…

Diagnosis and Management of Heart Failure with Preserved Ejection Frac-tion: 10 Key Lessons

Heart failure with preserved ejection fraction (HFpEF) is a common clinical syndrome associated with high rates of morbidi-ty and mortality. Due to the lack of evidence-based therapies and increasing prevalence of HFpEF, clinicians are often con-fronted with these patients and yet have little guidan...

Descripción completa

Detalles Bibliográficos
Autores principales: A, Afşin Oktay, Shah, Sanjiv J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Bentham Science Publishers 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4347209/
https://www.ncbi.nlm.nih.gov/pubmed/24251461
http://dx.doi.org/10.2174/1573403X09666131117131217
_version_ 1782359792000434176
author A, Afşin Oktay
Shah, Sanjiv J
author_facet A, Afşin Oktay
Shah, Sanjiv J
author_sort A, Afşin Oktay
collection PubMed
description Heart failure with preserved ejection fraction (HFpEF) is a common clinical syndrome associated with high rates of morbidi-ty and mortality. Due to the lack of evidence-based therapies and increasing prevalence of HFpEF, clinicians are often con-fronted with these patients and yet have little guidance on how to effectively diagnose and manage them. Here we offer 10 key lessons to assist with the care of patients with HFpEF: (1) Know the difference between diastolic dysfunction, diastolic heart failure, and HFpEF; (2) diagnosing HFpEF is challenging, so be thorough and consider invasive hemodynamic testing to confirm the diagnosis; (3) a normal B-type natriuretic peptide does not exclude the diagnosis of HFpEF; (4) elevated pul-monary artery systolic pressure on echocardiography in the presence of a normal ejection fraction should prompt considera-tion of HFpEF; (5) use dynamic testing in evaluating the possibility of HFpEF in patients with unexplained dyspnea or exer-cise tolerance; (6) all patients with HFpEF should be systematically evaluated for the presence of coronary artery disease; (7) use targeted treatment for HFpEF patients based on their phenotypic classification; (8) treat HFpEF patients now by treating their comorbidities; (9) understand the importance of heart rate in HFpEF—lower is not always better; and (10) do not forget to consider rare diseases (“zebras”) as causes for HFpEF when evaluating and treating patients. Taken together, these 10 key lessons can help clinicians care for challenging patients with HFpEF while we eagerly await the results of ongoing HFpEF clinical trials and observational studies.
format Online
Article
Text
id pubmed-4347209
institution National Center for Biotechnology Information
language English
publishDate 2015
publisher Bentham Science Publishers
record_format MEDLINE/PubMed
spelling pubmed-43472092016-01-31 Diagnosis and Management of Heart Failure with Preserved Ejection Frac-tion: 10 Key Lessons A, Afşin Oktay Shah, Sanjiv J Curr Cardiol Rev Article Heart failure with preserved ejection fraction (HFpEF) is a common clinical syndrome associated with high rates of morbidi-ty and mortality. Due to the lack of evidence-based therapies and increasing prevalence of HFpEF, clinicians are often con-fronted with these patients and yet have little guidance on how to effectively diagnose and manage them. Here we offer 10 key lessons to assist with the care of patients with HFpEF: (1) Know the difference between diastolic dysfunction, diastolic heart failure, and HFpEF; (2) diagnosing HFpEF is challenging, so be thorough and consider invasive hemodynamic testing to confirm the diagnosis; (3) a normal B-type natriuretic peptide does not exclude the diagnosis of HFpEF; (4) elevated pul-monary artery systolic pressure on echocardiography in the presence of a normal ejection fraction should prompt considera-tion of HFpEF; (5) use dynamic testing in evaluating the possibility of HFpEF in patients with unexplained dyspnea or exer-cise tolerance; (6) all patients with HFpEF should be systematically evaluated for the presence of coronary artery disease; (7) use targeted treatment for HFpEF patients based on their phenotypic classification; (8) treat HFpEF patients now by treating their comorbidities; (9) understand the importance of heart rate in HFpEF—lower is not always better; and (10) do not forget to consider rare diseases (“zebras”) as causes for HFpEF when evaluating and treating patients. Taken together, these 10 key lessons can help clinicians care for challenging patients with HFpEF while we eagerly await the results of ongoing HFpEF clinical trials and observational studies. Bentham Science Publishers 2015-02 2015-02 /pmc/articles/PMC4347209/ /pubmed/24251461 http://dx.doi.org/10.2174/1573403X09666131117131217 Text en © 2015 Bentham Science Publishers http://creativecommons.org/licenses/by-nc/3.0/ This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.
spellingShingle Article
A, Afşin Oktay
Shah, Sanjiv J
Diagnosis and Management of Heart Failure with Preserved Ejection Frac-tion: 10 Key Lessons
title Diagnosis and Management of Heart Failure with Preserved Ejection Frac-tion: 10 Key Lessons
title_full Diagnosis and Management of Heart Failure with Preserved Ejection Frac-tion: 10 Key Lessons
title_fullStr Diagnosis and Management of Heart Failure with Preserved Ejection Frac-tion: 10 Key Lessons
title_full_unstemmed Diagnosis and Management of Heart Failure with Preserved Ejection Frac-tion: 10 Key Lessons
title_short Diagnosis and Management of Heart Failure with Preserved Ejection Frac-tion: 10 Key Lessons
title_sort diagnosis and management of heart failure with preserved ejection frac-tion: 10 key lessons
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4347209/
https://www.ncbi.nlm.nih.gov/pubmed/24251461
http://dx.doi.org/10.2174/1573403X09666131117131217
work_keys_str_mv AT aafsinoktay diagnosisandmanagementofheartfailurewithpreservedejectionfraction10keylessons
AT shahsanjivj diagnosisandmanagementofheartfailurewithpreservedejectionfraction10keylessons