Heart failure with preserved ejection fraction: New approaches to diagnosis and management

The majority of older patients who develop heart failure (HF), particularly older women, have a preserved left ventricular ejection fraction (HFpEF). Patients with HFpEF have severe symptoms of exercise intolerance, poor quality‐of‐life, frequent hospitalizations, and increased mortality. The preval...

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Vydáno v:	Clinical cardiology (Mahwah, N.J.) Ročník 43; číslo 2; s. 145 - 155
Hlavní autoři:	Upadhya, Bharathi, Kitzman, Dalane W.
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	New York Wiley Periodicals, Inc 01.02.2020 John Wiley & Sons, Inc
Témata:	Age Factors Aged Aged, 80 and over Aging Biomarkers Cardiology Cell adhesion & migration Chronic obstructive pulmonary disease Clinical outcomes Clinical trials Comorbidity Drug development Ejection fraction Exercise Female geriatric syndrome Heart failure Heart Failure - diagnosis Heart Failure - epidemiology Heart Failure - physiopathology Heart Failure - therapy Humans Hypertension Inflammation Kinases Male Mortality Musculoskeletal system Obesity Older people Physical fitness Predictive Value of Tests preserved ejection fraction Quality of Life Recovery of Function Review Reviews Risk Assessment Risk Factors Stroke Volume therapy Time Factors Treatment Outcome Ultrasonic imaging Ventricular Function, Left preserved ejection fraction heart failure geriatric syndrome aging therapy
ISSN:	0160-9289, 1932-8737, 1932-8737
On-line přístup:	Získat plný text
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Popis
Shrnutí:	The majority of older patients who develop heart failure (HF), particularly older women, have a preserved left ventricular ejection fraction (HFpEF). Patients with HFpEF have severe symptoms of exercise intolerance, poor quality‐of‐life, frequent hospitalizations, and increased mortality. The prevalence of HFpEF is increasing and its prognosis is worsening. However, despite its importance, our understanding of the pathophysiology of HFpEF is incomplete, and drug development has proved immensely challenging. Currently, there are no universally accepted therapies that alter the clinical course of HFpEF. Originally viewed as a disorder due solely to abnormalities in left ventricular (LV) diastolic function, our understanding has evolved such that HFpEF is now understood as a systemic syndrome, involving multiple organ systems, likely triggered by inflammation and with an important contribution of aging, lifestyle factors, genetic predisposition, and multiple‐comorbidities, features that are typical of a geriatric syndrome. HFpEF is usually progressive due to complex mechanisms of systemic and cardiac adaptation that vary over time, particularly with aging. In this review, we examine evolving data regarding HFpEF that may help explain past challenges and provide future directions to care patients with this highly prevalent, heterogeneous clinical syndrome.
Bibliografie:	Funding information national institue of health, Grant/Award Numbers: R01AG045551, R01AG18915 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 ObjectType-Review-3 content type line 23 Funding information national institue of health, Grant/Award Numbers: R01AG045551, R01AG18915
ISSN:	0160-9289 1932-8737 1932-8737
DOI:	10.1002/clc.23321