Epidemiology of heart failure with preserved ejection fraction

Abstract

Heart failure (HF) with preserved ejection fraction (HFpEF) is a clinical syndrome associated with poor quality of life, substantial health-care resource utilization, and premature mortality. We summarize the current knowledge regarding the epidemiology of HFpEF with a focus on community-based studies relevant to quantifying the population burden of HFpEF. Current data regarding the prevalence and incidence of HFpEF in the community as well as associated conditions and risk factors, risk of morbidity and mortality after diagnosis, and quality of life are presented. In the community, approximately 50% of patients with HF have HFpEF. Although the age-specific incidence of HF is decreasing, this trend is less dramatic for HFpEF than for HF with reduced ejection fraction (HFrEF). The risk of HFpEF increases sharply with age, but hypertension, obesity, and coronary artery disease are additional risk factors. After adjusting for age and other risk factors, the risk of HFpEF is fairly similar in men and women, whereas the risk of HFrEF is much lower in women. Multimorbidity is common in both types of HF, but slightly more severe in HFpEF. A majority of deaths in patients with HFpEF are cardiovascular, but the proportion of noncardiovascular deaths is higher in HFpEF than HFrEF.

Novel heart failure biomarkers: why do we fail to exploit their potential?

“…Hypertension, on the other hand, may drive concentric hypertrophy and interstitial fibrosis, resulting in HF with preserved ejection fraction (HFpEF). Today HFpEF, which is often the result of hypertension, obesity, and aging, is becoming more prevalent [16]. A systemic proinflammatory state that causes coronary microvascular endothelial inflammation has been proposed as one of the main mechanisms that drive HFpEF development [9].…”

Role of Gender Specifics in Myocardial Remodelling, Cardiovascular Complications Development and Efficacy of Pharmacotherapy in Heart Failure Patients After Cardiac Surgery

“…Наиболее значимыми факторами риска хронической СН (ХСН) у женщин являются артериальная гипертензия (АГ), сахарный диабет (СД) и клапанные пороки сердца [1]. Важнейшей особенностью СН у женщин счита-ется формирование концентрического типа геомет-рии левого желудочка (ЛЖ) с развитием в большин-стве случаев СН с сохраненной фракцией выброса (СНсФВ) в отличие от мужчин, где преобладающим фенотипом является СН с низкой фракцией выброса (СНнФВ) [2]. Недавние исследования связывают данный факт с кардиопротективным действием эстрогенов на миокард [3].…”

Sex-specific differences in cardiac maladaptation to hypertension and arterial stiffening

“…While traditionally associated with the concept of pump failure or reduced left ventricular (LV) ejection fraction (EF), it has become widely recognised that HF can occur even when EF is preserved, constituting the syndrome of HF with preserved EF (HFpEF) [7]. Symptomatic HF has a poor prognosis, regardless of whether EF is reduced or not [8][9][10].…”