Heart failure with preserved ejection fraction: an update on pathophysiology, diagnosis, treatment, and prognosis

Ma, Chi; Luo, Huan; Fan, Lei; Liu, Xiaoyan; Gao, Chengshan

doi:10.1590/1414-431x20209646

Cited by 31 publications

(14 citation statements)

References 72 publications

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“…LVDEP>16 mm Hg was taken as a major indicator of LV diastolic dysfunction. 13 All patients gave their written consent to participate in the study, which was approved by the local ethical committee.…”

Section: Age and Sex Distributionmentioning

confidence: 99%

To determine the correlation between echocardiographic diastolic parameters and invasively measured left ventricular end diastolic pressure in patients with heart failure with preserved ejection fraction- an observational, descriptive study. (CEAL-HFpEF study)

Sharma

Kumar

Razi

et al. 2021

Indian Heart Journal

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Objectives Though invasive monitoring is the most accurate to estimate diastolic dysfunction but it has its own risk. The purpose of this study was to find out any standardized correlation between invasive and non -invasive parameters. Methods It is an observational, descriptive study comprising of a total of 500 patients. The primary objective of the study was to determine the correlation between echocardiographic diastolic parameters and invasively measured left ventricular end diastolic pressure (LVEDP). Results On studying correlation of different invasive and non-invasive data it was reported that there was a weak correlation between peak E velocity ( r = 0.14, p = 0.631), Peak A velocity ( r = 0.67, p = 0.59), IVRT ( r = −0.35, p = 0.178), Mitral deceleration time (DT) ( r = −0.06, p = 0.842), pulmonary venous peak systolic ( r = −0.02, p = 0.966) and diastolic flows ( r = 0.47, p = 0.201) to LVEDP. There was a good positive correlation between elevated LVEDP and difference in duration of pulmonary venous and mitral flow at atrial contraction (A-Ard) and E/Ea at all four longitudinal segments of the left ventricle. The sensitivity and specificity for detecting an elevated LVEDP of more than 12 mm Hg, using a cut off value of E/Ea< 8, were 89% and 90%.Lateral E/Ea ≥ 12, LAVI ≥34 mL/m2, and Ard–Ad > 30 msec have the greatest diagnostic value for diagnosing diastolic dysfunction in HFpEF patients. Conclusion Lateral E/Ea ≥ 12, LAVI ≥34 mL/m2, and Ard–Ad > 30 msec have the greatest diagnostic value for diagnosing diastolic dysfunction in HFpEF patients and have good correlation with invasively measured LVEDP.

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Section: Age and Sex Distributionmentioning

confidence: 99%

To determine the correlation between echocardiographic diastolic parameters and invasively measured left ventricular end diastolic pressure in patients with heart failure with preserved ejection fraction- an observational, descriptive study. (CEAL-HFpEF study)

Sharma

Kumar

Razi

et al. 2021

Indian Heart Journal

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“…Estima-se que aproximadamente 50% dos 6,5 milhões de indivíduos com IC sejam pacientes com ICFEP. Ademais, o risco de morte em pacientes com ICFEP aumenta conforme se eleva as comorbidades, sendo que as taxas de mortalidade são mais altas do que nos controles pareados por idade da população em geral (MA et al, 2020;NAIR, 2020;PFEFFER;SHAH;BORLAUG, 2019;UPADHYA;KITZMAN, 2020).…”

Section: Introductionunclassified

Avanços na abordagem terapêutica da insuficiência cardíaca com fração de ejeção preservada (ICFEP): O uso de inibidores de SGLT-2

Júnior¹,

Souza²,

Cândido³

et al. 2023

Braz. J. Hea. Rev.

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A insuficiência cardíaca (IC) com fração de ejeção preservada (ICFEP) é a forma mais prevalente de IC em pacientes com mais de 65 anos e representa mais de 50% dos casos prevalentes de IC na população. As intervenções terapêuticas da ICFEP ainda estão sendo exploradas e pesquisadas, como o uso de inibidores de SGLT-2. O presente estudo de revisão buscou avaliar novos avanços na abordagem terapêutica da insuficiência cardíaca com fração de ejeção preservada (ICFEP) a partir do uso de inibidores de SGLT-2, documentados por meio de estudos clínicos e randomizados. Trata-se de uma pesquisa de revisão integrativa realizada por meio da base de dados PubMed, que levou em consideração os seguintes critérios de inclusão: ensaios clínicos e testes controlados e aleatórios; artigos publicados no último ano; que possuíam texto completo disponível e que abordassem acerca do uso de inibidores de SGLT-2 na ICFEP. Ficou constatado que a dapagliflozina resultou em melhora dos sintomas relacionados à insuficiência cardíaca e limitações físicas nesses pacientes, bem como a canagliflozina, a qual trouxe resultados de melhora rápida e clinicamente significativa dos sintomas de IC. Já a empagliflozina demonstrou uma redução significativa no risco de morte cardiovascular ou hospitalizações por insuficiência cardíaca. Por fim, verificou-se que a ipragliflozina pode contribuir, em determinados subgrupos, reduzindo o índice de massa ventricular esquerda e, ainda, uma redução dos níveis de NT-proBNP, um marcador de disfunção ventricular. Dessa forma, os inibidores de SGLT-2 se fazem importantes medicações para a terapêutica efetiva da ICFEP atualmente.

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“…The pathophysiological mechanism of HFpEF includes left ventricular (LV) structure and remodeling, LV diastolic limitations, and LV systolic limitations. Currently, however, no effective treatment drug exists ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of sacubitril/valsartan on heart failure with preserved ejection fraction: A meta-analysis of randomized controlled trials

Zhang

Shen

et al. 2022

Front. Cardiovasc. Med.

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AimsThe efficacy and safety of sacubitril/valsartan for patients with heart failure with preserved ejection fraction (HFpEF) are controversial. Hence, the primary objective of the study was to evaluate the efficacy and safety of sacubitril/valsartan treatment for patients with HFpEF.Methods and resultsWe used the PubMed, Embase, and Web of Science databases to search for randomized controlled trials of sacubitril–valsartan in patients with HFpEF. Three studies, involving a total of 7,663 patients, were eligible for inclusion. Sacubitril–valsartan reduced the risk of hospitalization for heart failure (HF) [odds ratio (OR): 0.78; 95% CI: 0.70–0.88; p < 0.0001] and the incidence of worsening renal function [risk ratio (RR): 0.79, p = 0.002] among patients with HFpEF in the three trials, but there was no significant reduction in all-cause mortality (0.99, 95% CI: 0.84–1.15; p = 0.86) or cardiovascular mortality (0.95, 95% CI: 0.78–1.15; p = 0.16). Moreover, sacubitril/valsartan was associated with an increased risk of symptomatic hypotension (RR: 1.44; p < 0.00001) and angioedema (RR: 2.66; p < 0.04); there was no difference for decreasing the incidence of hyperkalemia (RR: 0.89; p = 0.11).ConclusionCompared with valsartan or individualized medical therapy (IMT), sacubitril/valsartan significantly decreased the risk of hospitalization for HF and reduced the incidence of renal dysfunction.

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Heart failure with preserved ejection fraction: an update on pathophysiology, diagnosis, treatment, and prognosis

Cited by 31 publications

References 72 publications

To determine the correlation between echocardiographic diastolic parameters and invasively measured left ventricular end diastolic pressure in patients with heart failure with preserved ejection fraction- an observational, descriptive study. (CEAL-HFpEF study)

To determine the correlation between echocardiographic diastolic parameters and invasively measured left ventricular end diastolic pressure in patients with heart failure with preserved ejection fraction- an observational, descriptive study. (CEAL-HFpEF study)

Avanços na abordagem terapêutica da insuficiência cardíaca com fração de ejeção preservada (ICFEP): O uso de inibidores de SGLT-2

Efficacy and safety of sacubitril/valsartan on heart failure with preserved ejection fraction: A meta-analysis of randomized controlled trials

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