Heart Failure with Preserved Ejection Fraction: Time to Revisit the Stiff Heart

Abstract

In the current era of cardiovascular disease, the diagnosis of heart failure with preserved ejection fraction (HFpEF) is a well-recognized clinical entity that is equally prevalent but distinctly different from heart failure with reduced ejection fraction (HFrEF). Despite normal EF patients with this disease have similar morbidity and mortality rates compared with HFrEF, as well as a rising rate of hospitalizations. The pathophysiology of HFpEF is incompletely understood. The number of therapies with proven efficacy at improving longterm cardiovascular outcomes is limited. Women with heart failure syndromes, particularly the elderly, are much more likely to have a HFpEF phenotype at the time of their diagnosis. The purpose of this paper is to review the epidemiology, pathophysiology, clinical features, and current management strategies in HFpEF, especially as it pertains to women.

Prognostic implications of premature ventricular contractions and non-sustained ventricular tachycardia in light-chain cardiac amyloidosis

“…Since CA has gained more clinical recognition in the field of heart failure, 22 , 23 various arrhythmias ranging from brady- and tachyarrhythmias accompanying this disease have also been increasingly addressed. 5 In particular, VAs and their potential link to adverse clinical outcomes have been a matter of concern.…”

Leukocyte count and the risk of adverse outcomes in patients with HFpEF

“…In addition, the U-shaped relationship between leukocyte count and the risk of adverse cardiovascular outcomes persisted even aftercontrolling for baseline covariates.The U-shaped relationship may also be a potential reason for the unsuccessful clinical trials attempting to combat HFby blocking inflammation [ 11 ]. Although canakinumabis related to a dose-dependent reduction in heart failure relatedhospitalization and the composite of heart failure-related mortality and hospitalization, it is not efficient in all population but patients with elevatedhsCRP [ 31 ].Besides,interaction between inflammation and body weight, blood pressure, and blood glucose might jointly affect theoutcomes of HFpEF patients and the sum of the complex interaction may bealso responsible for the observedU-shaped relationshipin this study [ 32 – 35 ].…”