Heart Failure With Preserved Ejection Fraction: A Comprehensive Review and Update of Diagnosis, Pathophysiology, Treatment, and Perioperative Implications

Pagel, Paul S.; Tawil, Justin N.; Boettcher, Brent T.; Izquierdo, David; Lazicki, Timothy J.; Crystal, George J.; Freed, Julie K.

doi:10.1053/j.jvca.2020.07.016

Cited by 44 publications

(34 citation statements)

References 240 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…HFpEF is a group of syndromes with left ventricular diastolic dysfunction as the main clinical manifestation, often accompanied by risk factors such as advanced age, hypertension and diabetes [ 16 , 17 ], which was consistent with the characteristics of our cohort study. AASI was determined from the records of ABPM has been proposed as a surrogate indicator of arterial stiffness [ 1 , 2 ].…”

Section: Discussionsupporting

confidence: 90%

The relationship between ambulatory arterial stiffness index and left ventricular diastolic dysfunction in HFpEF: a prospective observational study

Zhang

Wang

Liu

et al. 2022

BMC Cardiovasc Disord

View full text Add to dashboard Cite

Background The relationship between ambulatory arterial stiffness index (AASI) and left ventricular diastolic dysfunction (LVDD) in patients with heart failure with preserved ejection fraction (HFpEF) is unknown. We aimed to investigate the association between the AASI and LVDD in HFpEF. Methods We prospective enrolled consecutive patients with HFpEF in Chongqing, China. Twenty-four-hour ambulatory blood pressure monitoring (24 h-ABPM) and echocardiography were performed in each patient. AASI was obtained through individual 24 h-ABPM. The relationship between AASI and LVDD was analyzed. Results A total of 107 patients with HFpEF were included. The mean age was 68.45 ± 14.02 years and 63 (59%) were women. The patients were divided into two groups according to the upper normal border of AASI (0.55). AASI > 0.55 group were more likely to be older, to have higher mean systolic blood pressure and worsen left ventricular diastolic function than AASI group ≤ 0.55. AASI was closely positive related to the diastolic function parameters, including mean E/e′ (r = 0.307, P = 0.001), septal E/e′ (r = 0.290, P = 0.002), lateral E/e′ (r = 0.276, P = 0.004) and E (r = 0.274, P = 0.004). After adjusting for conventional risk factors, AASI was still an independent risk factors of mean E/e′ > 10 in patients with HFpEF (OR: 2.929, 95%CI: 1.214–7.064, P = 0.017), and the association between AASI and mean E/e′ > 14 was reduced (OR: 2.457, 95%CI: 1.030–5.860, P = 0.043). AASI had a partial predictive value for mean E/e′ > 10 (AUC = 0.691, P = 0.002), while the predictive value for mean E/e′ > 14 was attenuated (AUC = 0.624, P = 0.034). Conclusion AASI was positive related to E/e′ in HFpEF and might be an independent risk factor for the increase of mean E/e′.

show abstract

Section: Discussionsupporting

confidence: 90%

The relationship between ambulatory arterial stiffness index and left ventricular diastolic dysfunction in HFpEF: a prospective observational study

Zhang

Wang

Liu

et al. 2022

BMC Cardiovasc Disord

View full text Add to dashboard Cite

show abstract

“…A number of factors could affect the prognosis of HFpEF (37)(38)(39)(40)(41). LV diastolic dysfunction plays a central role in the pathophysiology of HFpEF, defined as an impairment in relaxation or an increase in stiffness.…”

Section: Comorbidities and Prognostic Factors In Hfpefmentioning

confidence: 99%

Predictive Value of HFA-PEFF Score in Patients With Heart Failure With Preserved Ejection Fraction

Sun

et al. 2021

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

Aims: HFA-PEFF score has been proposed for diagnosing heart failure with preserved ejection fraction (HFpEF). Currently, there are only a limited number of tools for predicting the prognosis. In this study, we evaluated whether the HFA-PEFF score can predict mortality in patients with HFpEF.Methods: This single-center, retrospective observational study enrolled patients diagnosed with HFpEF at the First Affiliated Hospital of Dalian Medical University between January 1, 2015, and April 30, 2018. The subjects were divided according to their HFA-PEFF score into low (0–2 points), intermediate (3–4 points), and high (5–6 points) score groups. The primary outcome was all-cause mortality.Results: A total of 358 patients (mean age: 70.21 ± 8.64 years, 58.1% female) were included. Of these, 63 (17.6%), 156 (43.6%), and 139 (38.8%) were classified into the low, intermediate, and high score groups, respectively. Over a mean follow-up of 26.9 months, 46 patients (12.8%) died. The percentage of patients who died in the low, intermediate, and high score groups were 1 (1.6%), 18 (11.5%), and 27 (19.4%), respectively. A multivariate Cox regression identified HFA-PEFF score as an independent predictor of all-cause mortality [hazard ratio (HR):1.314, 95% CI: 1.013–1.705, P = 0.039]. A Cox analysis demonstrated a significantly higher rate of mortality in the intermediate (HR: 4.912, 95% CI 1.154–20.907, P = 0.031) and high score groups (HR: 5.291, 95% CI: 1.239–22.593, P = 0.024) than the low score group. A receiver operating characteristic (ROC) analysis indicated that the HFA-PEFF score can effectively predict all-cause mortality after adjusting for age and New York Heart Association (NYHA) class [area under the curve (AUC) 0.726, 95% CI 0.651–0.800, P = 0.000]. With an HFA-PEFF score cut-off value of 3.5, the sensitivity and specificity were 78.3 and 54.8%, respectively. The AUC on ROC analysis for the biomarker component of the score was similar to that of the total score.Conclusions: The HFA-PEFF score can be used both to diagnose HFpEF and predict the prognosis. The higher scores are associated with higher all-cause mortality.

show abstract

“…Many conditions were reported to be associated with HFpEF, for example, aging, hypertension, obesity, diabetes. Diastolic dysfunction is one of the most important contributor to HFpEF ( 8 ), and arterial stiffness is a well-established factor that accelerates the development of diastolic dysfunction. A meta-analysis which included 27 studies showed that, parameters of arterial stiffness especially brachial-ankle PWV, were significantly associated with diastolic dysfunction indicators recorded by echocardiography ( 9 ).…”

Section: Does Arterial Stiffness Relate To Hfpef?mentioning

confidence: 99%

Association Between Arterial Stiffness and Heart Failure With Preserved Ejection Fraction

Chen

Liu

2021

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

Cardiovascular diseases are the leading cause of mortality in the world. Heart failure with preserved ejection fraction (HFpEF) accounts for about half of all heart failure. Unfortunately, the mechanisms of HFpEF are still unclear, leading to little progress of effective treatment of HFpEF. Arterial stiffness is the decrement of arterial compliance. The media of large arteries degenerate in both physiological and pathological conditions. Many studies have proven that arterial stiffness is an independent risk factor for cardiovascular disorders including diastolic dysfunction. In this perspective, we discussed if arterial stiffness is related to HFpEF, and how does arterial stiffness contribute to HFpEF. Finally, we briefly summarized current treatment strategies on arterial stiffness and HFpEF. Though some new drugs were developed, the safety and effectiveness were not adequately assessed. New pharmacologic treatment for arterial stiffness and HFpEF are urgently needed.

show abstract

Heart Failure With Preserved Ejection Fraction: A Comprehensive Review and Update of Diagnosis, Pathophysiology, Treatment, and Perioperative Implications

Cited by 44 publications

References 240 publications

The relationship between ambulatory arterial stiffness index and left ventricular diastolic dysfunction in HFpEF: a prospective observational study

The relationship between ambulatory arterial stiffness index and left ventricular diastolic dysfunction in HFpEF: a prospective observational study

Predictive Value of HFA-PEFF Score in Patients With Heart Failure With Preserved Ejection Fraction

Association Between Arterial Stiffness and Heart Failure With Preserved Ejection Fraction

Contact Info

Product

Resources

About