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Reshaping Treatment of Heart Failure with Preserved Ejection Fraction
Current data indicate that in the community, approximately 50% of patients with heart failure (HF) have preserved left ventricular (LV) ejection fraction (LVEF)—the so-called HFpEF. Treatment of HFpEF has been considered an unmet need for decades. We believe that the main underlying reasons have bee...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9267897/ https://www.ncbi.nlm.nih.gov/pubmed/35806994 http://dx.doi.org/10.3390/jcm11133706 |
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author | Karamichalakis, Nikolaos Xanthopoulos, Andrew Triposkiadis, Filippos Paraskevaidis, Ioannis Tsougos, Elias |
author_facet | Karamichalakis, Nikolaos Xanthopoulos, Andrew Triposkiadis, Filippos Paraskevaidis, Ioannis Tsougos, Elias |
author_sort | Karamichalakis, Nikolaos |
collection | PubMed |
description | Current data indicate that in the community, approximately 50% of patients with heart failure (HF) have preserved left ventricular (LV) ejection fraction (LVEF)—the so-called HFpEF. Treatment of HFpEF has been considered an unmet need for decades. We believe that the main underlying reasons have been (a) the ever-changing LVEF cut-offs used for HF classification; (b) controversies regarding the definition of the LVEF normal range; (c) the fact that HFpEF does not represent a phenotype, but a category of diseases with entirely different characteristics (hypertensive heart disease, valvular heart disease (VHD), hypertrophic cardiomyopathy (HCM) etc.); (d) the lack of recognition that hypertensive HFpEF is the most common and important HFpEF phenotype; (e) the assumption that neurohormonal overactivity is absent in HF patients with a LVEF > 45–50% which has been proven to be wrong. Current HFpEF trials, in which the vast majority of the participants suffered from hypertension (HTN), whereas VHD and HCM were absent, demonstrated that neurohormonal and sodium-glucose cotransporter 2 (SGLT2) inhibitors are effective in HF patients over a wide LVEF range. Thus, restricting these lifesaving treatments to HF patients with reduced LVEF is not justified anymore and it should be additionally considered for HFpEF patients suffering from HTN. |
format | Online Article Text |
id | pubmed-9267897 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-92678972022-07-09 Reshaping Treatment of Heart Failure with Preserved Ejection Fraction Karamichalakis, Nikolaos Xanthopoulos, Andrew Triposkiadis, Filippos Paraskevaidis, Ioannis Tsougos, Elias J Clin Med Review Current data indicate that in the community, approximately 50% of patients with heart failure (HF) have preserved left ventricular (LV) ejection fraction (LVEF)—the so-called HFpEF. Treatment of HFpEF has been considered an unmet need for decades. We believe that the main underlying reasons have been (a) the ever-changing LVEF cut-offs used for HF classification; (b) controversies regarding the definition of the LVEF normal range; (c) the fact that HFpEF does not represent a phenotype, but a category of diseases with entirely different characteristics (hypertensive heart disease, valvular heart disease (VHD), hypertrophic cardiomyopathy (HCM) etc.); (d) the lack of recognition that hypertensive HFpEF is the most common and important HFpEF phenotype; (e) the assumption that neurohormonal overactivity is absent in HF patients with a LVEF > 45–50% which has been proven to be wrong. Current HFpEF trials, in which the vast majority of the participants suffered from hypertension (HTN), whereas VHD and HCM were absent, demonstrated that neurohormonal and sodium-glucose cotransporter 2 (SGLT2) inhibitors are effective in HF patients over a wide LVEF range. Thus, restricting these lifesaving treatments to HF patients with reduced LVEF is not justified anymore and it should be additionally considered for HFpEF patients suffering from HTN. MDPI 2022-06-27 /pmc/articles/PMC9267897/ /pubmed/35806994 http://dx.doi.org/10.3390/jcm11133706 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Karamichalakis, Nikolaos Xanthopoulos, Andrew Triposkiadis, Filippos Paraskevaidis, Ioannis Tsougos, Elias Reshaping Treatment of Heart Failure with Preserved Ejection Fraction |
title | Reshaping Treatment of Heart Failure with Preserved Ejection Fraction |
title_full | Reshaping Treatment of Heart Failure with Preserved Ejection Fraction |
title_fullStr | Reshaping Treatment of Heart Failure with Preserved Ejection Fraction |
title_full_unstemmed | Reshaping Treatment of Heart Failure with Preserved Ejection Fraction |
title_short | Reshaping Treatment of Heart Failure with Preserved Ejection Fraction |
title_sort | reshaping treatment of heart failure with preserved ejection fraction |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9267897/ https://www.ncbi.nlm.nih.gov/pubmed/35806994 http://dx.doi.org/10.3390/jcm11133706 |
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