title: Management of heart failure with preserved ejection fraction: a review.
abstract: OBJECTIVE
  The purpose of this article was to review the clinical management of patients with heart failure with preserved ejection fraction (HFPEF).
  
  
  METHODS
  For this critical review, electronic databases (MEDLINE, EMBASE, PubMed) were searched for relevant basic research studies and randomized clinical trials recently published or presented at major meetings. Details of in-progress or planned studies were obtained from the ClinicalTrials.gov website. The range of publication dates was the year 2000 to 2015. Search terms included HFPEF, heart failure with preserved ejection fraction, HFPSF, heart failure with preserved systolic function, diastolic heart failure, diastolic dysfunction, HFNEF, heart failure with normal ejection fraction, treatment, management, therapy.
  
  
  RESULTS
  Patients with HFPEF account for up to half of all patients with a clinical diagnosis of HF. Key contributing factors include hypertension, obesity, and atrial fibrillation, and other chronic diseases, including diabetes, chronic obstructive pulmonary disease, and anemia, frequently coexist. To date, large-scale clinical trials, particularly those focused on antagonism of the renin-angiotensin-aldosterone system, have provided limited evidence of clinical benefit.
  
  
  CONCLUSIONS
  The aggressive management of contributing factors, including hypertension, atrial fibrillation, and myocardial ischemia, is key in the management of HFPEF. New insights into the mechanisms and thus the identification of potential therapeutic strategies are urgently required.
authors.affiliation: Department of Cardiovascular Medicine, Alfred Hospital, Melbourne, Victoria, Australia; The Heart Failure Research Group, Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia.
authors.forename: Shane
authors.initials: S
authors.lastname: Nanayakkara
authors.affiliation: Department of Cardiovascular Medicine, Alfred Hospital, Melbourne, Victoria, Australia; The Heart Failure Research Group, Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia. Electronic address: david.kaye@bakeridi.edu.au.
authors.forename: David M
authors.initials: DM
authors.lastname: Kaye
mesh_terms: D001281:Atrial Fibrillation / Q000150:complications / Q000188:drug therapy; D002908:Chronic Disease; D019468:Disease Management; D006333:Heart Failure / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D009765:Obesity / Q000150:complications; D012084:Renin-Angiotensin System / Q000187:drug effects; D013318:Stroke Volume / Q000502:physiology*
keywords: HFPEF; heart failure; management; preserved ejection fraction; treatment