Current controversies in heart failure with a preserved ejection fraction.
Heart failure with a preserved ejection fraction is a fascinating and multifaceted condition that has provoked enormous debate and a wealth of mechanistic studies. Controversies exist with regard to its nomenclature. If its nomenclature is questioned, one can be certain the pathogenesis is ill understood. If the pathogenesis is disputed, the diagnosis becomes difficult and inconsistent. These diagnostic challenges result in inappropriate recruitment to clinical trials. Therefore, the trials may be underpowered and difficult to interpret. This paper examines contemporary theories of heart failure with a preserved ejection fraction, clarifies the controversies and attempts to resolve the divergences of opinion.
MacIver
David H
DH
Consultant cardiologist, Department of Cardiology, Taunton & Somerset Hospital, Musgrove Park, Taunton, TA1 5DA, UK. david.maciver@tst.nhs.uk
D054144:Heart Failure, Diastolic / Q000145:classification / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D054143:Heart Failure, Systolic / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000150:complications / Q000503:physiopathology; D011379:Prognosis; D013318:Stroke Volume; D009626:Terminology as Topic; D016277:Ventricular Function, Left