title: Heart failure with preserved ejection fraction: refocusing on diastole.
abstract: Heart failure (HF) with preserved ejection fraction (HFpEF) is a clinical syndrome of exercise intolerance and/or congestion, in the presence of a left ventricular (LV) ejection fraction within the normal limits (i.e. LVEF>50%). Determining the presence of impaired LV relaxation and/or filling (diastolic dysfunction) in HFpEF is needed to pragmatically to distinguish it from other cardiac and non-cardiac conditions where symptoms are not due to HF. There are multiple mechanisms for diastolic dysfunction ranging from structural abnormalities to functional derangements in HFpEF yet tailored therapies are lacking. Treatments proven effective in HF with systolic dysfunction have failed to show significant benefit in patients with HFpEF, which prognosis remains poor. This review will discuss the challenges inherent to the use of diagnostic criteria for HFpEF, differential diagnosis, prognostic evaluation, and treatment, highlighting the need for more research in this field.
authors.affiliation: VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA; Victoria Johnson Research Laboratories, Virginia Commonwealth University, Richmond, VA, USA. Electronic address: aabbate@vcu.edu.
authors.forename: Antonio
authors.initials: A
authors.lastname: Abbate
authors.affiliation: University of Illinois Chicago, Department of Physical Therapy, Chicago, IL, USA.
authors.forename: Ross
authors.initials: R
authors.lastname: Arena
authors.affiliation: VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA.
authors.forename: Nayef
authors.initials: N
authors.lastname: Abouzaki
authors.affiliation: VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA; Victoria Johnson Research Laboratories, Virginia Commonwealth University, Richmond, VA, USA; Department of Pharmacotherapy and Outcome Sciences, Virginia Commonwealth University, Richmond, VA, USA.
authors.forename: Benjamin W
authors.initials: BW
authors.lastname: Van Tassell
authors.affiliation: Department of Physical Therapy, Virginia Commonwealth University, Richmond, VA, USA.
authors.forename: Justin
authors.initials: J
authors.lastname: Canada
authors.affiliation: VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA.
authors.forename: Keyur
authors.initials: K
authors.lastname: Shah
authors.affiliation: Sapienza University of Rome, Department of Medico-Surgical Sciences and Biotechnologies, Latina, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Biondi-Zoccai
authors.affiliation: Victoria Johnson Research Laboratories, Virginia Commonwealth University, Richmond, VA, USA.
authors.forename: Norbert F
authors.initials: NF
authors.lastname: Voelkel
mesh_terms: D003937:Diagnosis, Differential; D003971:Diastole / Q000502:physiology*; D006333:Heart Failure / Q000175:diagnosis* / Q000503:physiopathology*; D006801:Humans; D012307:Risk Factors; D013318:Stroke Volume / Q000502:physiology*; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology
keywords: Cardiopulmonary; Diastole; Exercise; Heart failure; Physiology