title: After TOPCAT: What to do now in Heart Failure with Preserved Ejection Fraction.
abstract: Although patients with heart failure and preserved ejection fraction (HF-PEF) represent nearly half of the population with chronic heart failure, few evidence-based medical therapies are available. The neutral overall results of the TOPCAT trial of spironolactone in HF-PEF leave clinicians who treat heart failure with an ongoing clinical dilemma. In this review, we outline an approach to the clinical management of the patient with HF-PEF synthesizing data from available clinical trials and expert consensus.
authors.affiliation: Cardiovascular Division, Brigham and Women's Hospital, 75 Francis Street, MA 02115, Boston, USA adesai@partners.org.
authors.forename: Akshay S
authors.initials: AS
authors.lastname: Desai
authors.affiliation: British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
authors.forename: Pardeep S
authors.initials: PS
authors.lastname: Jhund
mesh_terms: D006333:Heart Failure; D006801:Humans; D000451:Mineralocorticoid Receptor Antagonists; D013148:Spironolactone; D013318:Stroke Volume
chemical_list: D000451:Mineralocorticoid Receptor Antagonists; D013148:Spironolactone
keywords: Clinical management; Heart failure with preserved ejection fraction; Spironolactone