Diagnosis and Management of Heart Failure with Preserved Ejection Fraction: 10 Key Lessons
Heart failure with preserved ejection fraction (HFpEF) is a common clinical syndrome associated with high rates of morbidity and mortality. Due to the lack of evidence-based therapies and increasing prevalence of HFpEF, clinicians are often confronted with these patients and yet have little guidance...
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description | Heart failure with preserved ejection fraction (HFpEF) is a common clinical syndrome associated with high
rates of morbidity and mortality. Due to the lack of evidence-based therapies and increasing prevalence of HFpEF, clinicians
are often confronted with these patients and yet have little guidance on how to effectively diagnose and manage
them. Here we offer 10 key lessons to assist with the care of patients with HFpEF: (1) Know the difference between diastolic
dysfunction, diastolic heart failure, and HFpEF; (2) diagnosing HFpEF is challenging, so be thorough and consider
invasive hemodynamic testing to confirm the diagnosis; (3) a normal B-type natriuretic peptide does not exclude the diagnosis
of HFpEF; (4) elevated pulmonary artery systolic pressure on echocardiography in the presence of a normal ejection
fraction should prompt consideration of HFpEF; (5) use dynamic testing in evaluating the possibility of HFpEF in patients
with unexplained dyspnea or exercise tolerance; (6) all patients with HFpEF should be systematically evaluated for the
presence of coronary artery disease; (7) use targeted treatment for HFpEF patients based on their phenotypic classification;
(8) treat HFpEF patients now by treating their comorbidities; (9) understand the importance of heart rate in HFpEF-
lower is not always better; and (10) do not forget to consider rare diseases ("zebras") as causes for HFpEF when evaluating
and treating patients. Taken together, these 10 key lessons can help clinicians care for challenging patients with
HFpEF while we eagerly await the results of ongoing HFpEF clinical trials and observational studies. |
doi_str_mv | 10.2174/1573403x09666131117131217 |
format | Article |
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rates of morbidity and mortality. Due to the lack of evidence-based therapies and increasing prevalence of HFpEF, clinicians
are often confronted with these patients and yet have little guidance on how to effectively diagnose and manage
them. Here we offer 10 key lessons to assist with the care of patients with HFpEF: (1) Know the difference between diastolic
dysfunction, diastolic heart failure, and HFpEF; (2) diagnosing HFpEF is challenging, so be thorough and consider
invasive hemodynamic testing to confirm the diagnosis; (3) a normal B-type natriuretic peptide does not exclude the diagnosis
of HFpEF; (4) elevated pulmonary artery systolic pressure on echocardiography in the presence of a normal ejection
fraction should prompt consideration of HFpEF; (5) use dynamic testing in evaluating the possibility of HFpEF in patients
with unexplained dyspnea or exercise tolerance; (6) all patients with HFpEF should be systematically evaluated for the
presence of coronary artery disease; (7) use targeted treatment for HFpEF patients based on their phenotypic classification;
(8) treat HFpEF patients now by treating their comorbidities; (9) understand the importance of heart rate in HFpEF-
lower is not always better; and (10) do not forget to consider rare diseases ("zebras") as causes for HFpEF when evaluating
and treating patients. Taken together, these 10 key lessons can help clinicians care for challenging patients with
HFpEF while we eagerly await the results of ongoing HFpEF clinical trials and observational studies.</description><identifier>ISSN: 1573-403X</identifier><identifier>EISSN: 1875-6557</identifier><identifier>DOI: 10.2174/1573403x09666131117131217</identifier><identifier>PMID: 24251461</identifier><language>eng</language><publisher>United Arab Emirates: Bentham Science Publishers Ltd</publisher><subject>Animals ; Echocardiography ; Heart Failure - diagnosis ; Heart Failure - physiopathology ; Heart Failure - therapy ; Heart Rate ; Hemodynamics ; Humans ; Natriuretic Peptide, Brain - blood</subject><ispartof>Current cardiology reviews, 2015-01, Vol.11 (1), p.42-52</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b492t-c11a8a2d933ea8608a6c2d4df3858d57ae1746d62010db8148b4431f6558895a3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24251461$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Oktay, A Afşin</creatorcontrib><creatorcontrib>Shah, Sanjiv J</creatorcontrib><title>Diagnosis and Management of Heart Failure with Preserved Ejection Fraction: 10 Key Lessons</title><title>Current cardiology reviews</title><addtitle>CCR</addtitle><description>Heart failure with preserved ejection fraction (HFpEF) is a common clinical syndrome associated with high
rates of morbidity and mortality. Due to the lack of evidence-based therapies and increasing prevalence of HFpEF, clinicians
are often confronted with these patients and yet have little guidance on how to effectively diagnose and manage
them. Here we offer 10 key lessons to assist with the care of patients with HFpEF: (1) Know the difference between diastolic
dysfunction, diastolic heart failure, and HFpEF; (2) diagnosing HFpEF is challenging, so be thorough and consider
invasive hemodynamic testing to confirm the diagnosis; (3) a normal B-type natriuretic peptide does not exclude the diagnosis
of HFpEF; (4) elevated pulmonary artery systolic pressure on echocardiography in the presence of a normal ejection
fraction should prompt consideration of HFpEF; (5) use dynamic testing in evaluating the possibility of HFpEF in patients
with unexplained dyspnea or exercise tolerance; (6) all patients with HFpEF should be systematically evaluated for the
presence of coronary artery disease; (7) use targeted treatment for HFpEF patients based on their phenotypic classification;
(8) treat HFpEF patients now by treating their comorbidities; (9) understand the importance of heart rate in HFpEF-
lower is not always better; and (10) do not forget to consider rare diseases ("zebras") as causes for HFpEF when evaluating
and treating patients. Taken together, these 10 key lessons can help clinicians care for challenging patients with
HFpEF while we eagerly await the results of ongoing HFpEF clinical trials and observational studies.</description><subject>Animals</subject><subject>Echocardiography</subject><subject>Heart Failure - diagnosis</subject><subject>Heart Failure - physiopathology</subject><subject>Heart Failure - therapy</subject><subject>Heart Rate</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Natriuretic Peptide, Brain - blood</subject><issn>1573-403X</issn><issn>1875-6557</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNplkU1v1DAQhiMEoqXwF5C5cQl4_BWHGypdilgEB5AqLpaTTHZdEju1ky4988fxdpdeuNivNM_Y48dF8QroGwaVeAuy4oLy37RWSgEHgCqvufSoOAVdyVJJWT3OOXNlBq9OimcpXVMqmarhaXHCBJMgFJwWPz84u_EhuUSs78gX6-0GR_QzCT25RBtnsrJuWCKSnZu35FvEhPEWO3Jxje3sgieraO_DOwKUfMY7ssaUgk_Piye9HRK-OO5nxY_Vxffzy3L99eOn8_frshE1m8sWwGrLuppztFpRbVXLOtH1XEvdycpifrLqFKNAu0aD0I0QHPr8Rq1raflZ8fpw7hTDzYJpNqNLLQ6D9RiWZEAxyYWkvMpofUDbGFKK2JsputHGOwPU7NWao9qr_9Tm3pfHa5ZmxO6h85_LDPw5AE3Wt7Vjah36Fh_A7TxPZrfbGcw2f9mEQxZo2jCaMKFf4pCzn3OvmbaT2aCPaLJ_1w5oXEr-fjazH87chmEZ0QDsC0sOJk3534xg_C-riKXO</recordid><startdate>20150101</startdate><enddate>20150101</enddate><creator>Oktay, A Afşin</creator><creator>Shah, Sanjiv J</creator><general>Bentham Science Publishers Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20150101</creationdate><title>Diagnosis and Management of Heart Failure with Preserved Ejection Fraction: 10 Key Lessons</title><author>Oktay, A Afşin ; Shah, Sanjiv J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b492t-c11a8a2d933ea8608a6c2d4df3858d57ae1746d62010db8148b4431f6558895a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Animals</topic><topic>Echocardiography</topic><topic>Heart Failure - diagnosis</topic><topic>Heart Failure - physiopathology</topic><topic>Heart Failure - therapy</topic><topic>Heart Rate</topic><topic>Hemodynamics</topic><topic>Humans</topic><topic>Natriuretic Peptide, Brain - blood</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Oktay, A Afşin</creatorcontrib><creatorcontrib>Shah, Sanjiv J</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Current cardiology reviews</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Oktay, A Afşin</au><au>Shah, Sanjiv J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diagnosis and Management of Heart Failure with Preserved Ejection Fraction: 10 Key Lessons</atitle><jtitle>Current cardiology reviews</jtitle><addtitle>CCR</addtitle><date>2015-01-01</date><risdate>2015</risdate><volume>11</volume><issue>1</issue><spage>42</spage><epage>52</epage><pages>42-52</pages><issn>1573-403X</issn><eissn>1875-6557</eissn><abstract>Heart failure with preserved ejection fraction (HFpEF) is a common clinical syndrome associated with high
rates of morbidity and mortality. Due to the lack of evidence-based therapies and increasing prevalence of HFpEF, clinicians
are often confronted with these patients and yet have little guidance on how to effectively diagnose and manage
them. Here we offer 10 key lessons to assist with the care of patients with HFpEF: (1) Know the difference between diastolic
dysfunction, diastolic heart failure, and HFpEF; (2) diagnosing HFpEF is challenging, so be thorough and consider
invasive hemodynamic testing to confirm the diagnosis; (3) a normal B-type natriuretic peptide does not exclude the diagnosis
of HFpEF; (4) elevated pulmonary artery systolic pressure on echocardiography in the presence of a normal ejection
fraction should prompt consideration of HFpEF; (5) use dynamic testing in evaluating the possibility of HFpEF in patients
with unexplained dyspnea or exercise tolerance; (6) all patients with HFpEF should be systematically evaluated for the
presence of coronary artery disease; (7) use targeted treatment for HFpEF patients based on their phenotypic classification;
(8) treat HFpEF patients now by treating their comorbidities; (9) understand the importance of heart rate in HFpEF-
lower is not always better; and (10) do not forget to consider rare diseases ("zebras") as causes for HFpEF when evaluating
and treating patients. Taken together, these 10 key lessons can help clinicians care for challenging patients with
HFpEF while we eagerly await the results of ongoing HFpEF clinical trials and observational studies.</abstract><cop>United Arab Emirates</cop><pub>Bentham Science Publishers Ltd</pub><pmid>24251461</pmid><doi>10.2174/1573403x09666131117131217</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
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source | MEDLINE; EZB-FREE-00999 freely available EZB journals; PubMed Central |
subjects | Animals Echocardiography Heart Failure - diagnosis Heart Failure - physiopathology Heart Failure - therapy Heart Rate Hemodynamics Humans Natriuretic Peptide, Brain - blood |
title | Diagnosis and Management of Heart Failure with Preserved Ejection Fraction: 10 Key Lessons |
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