Heart failure with normal left ventricular ejection fraction.
It is estimated that approximately 50% of the heart failure population has a normal left ventricular ejection fraction, a complex broadly referred to as heart failure with normal left ventricular ejection fraction (HFNEF). While these patients have been considered in epidemiologic studies and clinical trials to represent a single pool of patients, limited more detailed studies indicate that HFNEF patients are a very heterogeneous group, with a number of key pathophysiologic mechanisms. This review summarizes and critically analyzes available data on the pathophysiology of HFNEF, placing it into context with a recently developed diagnostic algorithm. We evaluate the utility of commonly applied echocardiographic measures and biomarkers and integrate mechanistic observations into potential future therapeutic directions.
Maeder
Micha T
MT
Heart Failure Research Group, Baker IDI Heart and Diabetes Institute, and Heart Center, Alfred Hospital, St Kilda Road, Central Melbourne 8008 VIC, Australia.
Kaye
David M
DM
D000465:Algorithms; D001281:Atrial Fibrillation / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D002304:Cardiac Pacing, Artificial; D003324:Coronary Artery Disease / Q000503:physiopathology; D003971:Diastole / Q000502:physiology; D004417:Dyspnea / Q000209:etiology / Q000503:physiopathology; D015150:Echocardiography, Doppler; D015444:Exercise / Q000502:physiology; D006333:Heart Failure / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006439:Hemodynamics; D006801:Humans; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010101:Oxygen Consumption / Q000502:physiology; D010446:Peptide Fragments / Q000097:blood; D013318:Stroke Volume; D013599:Systole / Q000502:physiology; D016277:Ventricular Function, Left / Q000502:physiology*
D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain