TY - CHAP M1 - Book, Section TI - Diagnosis and Management of Heart Failure with Preserved Ejection Fraction A1 - Ferreira, João Pedro A1 - Sharma, Kavita A1 - Butler, Javed A2 - Fuster, Valentin A2 - Narula, Jagat A2 - Vaishnava, Prashant A2 - Leon, Martin B. A2 - Callans, David J. A2 - Rumsfeld, John A2 - Poppas, Athena PY - 2022 T2 - Fuster and Hurst's The Heart, 15e AB - Chapter SummaryThis chapter provides an in-depth description of heart failure with preserved ejection fraction (HFpEF), from pathophysiology to treatment. Patients with HFpEF have a multifaceted constellation of comorbidities and clinical presentations. Numerous pathogenic mechanisms, including diastolic dysfunction, impaired systolic reserve, abnormal ventricular-arterial coupling, inflammation, endothelial dysfunction, chronotropic incompetence, altered myocardial energetics, impaired peripheral skeletal muscle metabolism and perfusion, pulmonary hypertension, atrial fibrillation, coronary artery disease, obesity, and renal insufficiency, contribute to the disease burden of HFpEF (see Fuster and Hurst's Central Illustration). The prognosis of patients with HFpEF remains poor. Many treatments (including angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, mineralocorticoid receptor antagonists, sacubitril/valsartan, and sodium glucose cotransporter-2 inhibitors) have been tested in HFpEF. Candesartan, spironolactone, and sacubitril/valsartan all demonstrated a modest effect to reduce heart failure hospitalizations in patients with HFpEF, at least up to left ventricular ejection fractions in the 50% to 55% range. Empagliflozin showed a more pronounced effect to reduce the composite of heart failure hospitalizations or cardiovascular death across the spectrum of ejection fraction of HFpEF patients. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2023/02/07 UR - accesscardiology.mhmedical.com/content.aspx?aid=1191377021 ER -