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.