Heart failure with preserved ejection fraction

Heart failure with preserved ejection fraction (HF/pEF) is commonly understood as manifestation of signs and symptoms of heart failure with an ejection fraction greater than 50%. Roughly half of heart failure patients have reduced ejection fraction and half have preserved ejection fraction.

HF/pEF is characterized by a decrease in left ventricular compliance, leading to increased pressure in the left ventricle. Increased left atrial size is often seen with HF/pEF as a result of the poor left ventricular function. There is an increased risk for congestive heart failure, atrial fibrillation, and pulmonary hypertension. Risk factors are hypertension, hyperlipidemia, diabetes, smoking, and obstructive sleep apnea. There is a query about how this rendering may describe diastolic heart failure. Senile systemic amyloidosis, resulting from accumulation of aggregated wild-type transthyretin as part of the degenerative aging process, is emerging as an important and underdiagnosed contributor to HF/pEF with age.

Randomized studies on HF/pEF patients have shown that exercise has a positive lusitropic effect on left ventricular diastolic function (that is, it improves the ability of the left ventricle to relax after contraction), associated with improved aerobic exercise capacity.

HF/pEF is best tested-for by analyzing diastolic function during exercise.

Despite the rising incidence of the condition, and serious morbidity and mortality associated with the disease, trials of therapy have largely been negative. Understanding and targeting mechanisms will be key to effective therapy.

See also

• Diastolic heart failure

External links

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