Principles for diagnosing heart failure with preserved ejection fraction

Abstract

Low-grade systemic inflammation, myocardial stress, and extracellular matrix fibrosis lead to heart failure with preserved ejection fraction (HFpEF). The HFA-PEFF diagnostic algorithm and the H2FPEF score are recommended for detecting HFpEF. Their low compliance is the reason for improving the methods for diagnosing HFpEF. Modern paraclinical diagnostics of HFpEF includes an assessment of the left ventricular filling pressure during diastolic stress test. Phase analysis of left atrial strain during resting echocardiography may be promising to conclude an increase in mean left atrial pressure. Research interest is growing in relation to biomarkers involved in the regulation of collagen synthesis. Together, paraclinical diagnostics help to characterize sequential morphofunctional cardiac remodeling, increasing the possibility of HFpEF detection.

Keywords

• heart failure
• diastolic dysfunction
• diastolic stress test
• left atrium
• myocardial stress