Heart failure with preserved ejection fraction.
Progressive aging of the population and prolongation of life expectancy have led to the rising prevalence of heart failure (HF). Despite the improvements in medical therapy, the mortality rate of this condition has remained unacceptably high, becoming the primary cause of death in the elderly population. Almost half of patients with signs and symptoms of HF are found to have a nearly normal ejection fraction, which delineates a distinct clinical syndrome, known as HF with preserved ejection fraction (HF-PEF). While early research focused on the importance of diastolic dysfunction, more recent studies reported the pathophysiological complexity of the disease with multiple cardiovascular abnormalities contributing to its development and progression. HF-PEF is a challenging major health problem with yet no solution as there is no evidence-based treatment which improves clinical outcomes. This review summarizes the state of current knowledge on diagnosis, prognosis and treatment of HF-PEF, with particular insights on the pathological characteristics in the elderly population.
Awhina Health Campus, Waitakere Hospital, Waitemata District Health Board, Private Bag 93-503, Auckland, New Zealand ; Division of Cardiology, University of Verona, Ospedale Maggiore, Ple Stefani 1, 37126 Verona, Italy.
Marzia
M
Rigolli
Awhina Health Campus, Waitakere Hospital, Waitemata District Health Board, Private Bag 93-503, Auckland, New Zealand ; Faculty of Social and Health Sciences, Unitec Institute of Technology, Private Bag 92025, Auckland, New Zealand.
Gillian A
GA
Whalley
Diastole; Echocardiography; Heart failure; Mortality; Preserved ejection fraction