- Xiyuan Hospital of China Academy of Chinese Medical Sciences, National Clinical Research Center for Chinese Medicine Cardiology, Beijing 100091, P. R. China;
Heart failure with preserved ejection fraction (HFpEF) is the main type of heart failure (HF), accounting for more than half of the incidence of HF. However, the etiology, pathogenesis, treatment and prognosis of HFpEF are still not fully understood. Recommendations for HFpEF are in different chapters in the 2022 AHA/ACC/HFSA guideline for the management of heart failure. This paper interpreted the definition, stage, diagnosis, epidemiology, clinical evaluation, stage treatment, acute attack stage, comorbidity management, vulnerable population and research prospect of HFpEF, which aimed to provide the latest thinking in terms of the management of HFpEF for clinicians.
Citation: DONG Guoju. Interpretation of updated key points of heart failure with preserved ejection fraction in the 2022 AHA/ACC/HFSA guideline for the management of heart failure. Chinese Journal of Evidence-Based Medicine, 2022, 22(10): 1117-1124. doi: 10.7507/1672-2531.202205118 Copy
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- 2. Ho JE, Zern EK, Wooster L, et al. Differential clinical profiles, exercise responses, and outcomes associated with existing HFpEF definitions. Circulation, 2019, 140(5): 353-365.
- 3. Yancy CW, Jessup M, Bozkurt B, et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol, 2013, 62(16): e147-239.
- 4. Hunt SA, Abraham WT, Chin MH, et al. 2009 focused update incorporated into the ACC/AHA 2005 guidelines for the diagnosis and management of heart failure in adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation, 2009, 119(14): e391-479.
- 5. Madsen BK, Hansen JF, Stokholm KH, et al. Chronic congestive heart failure. description and survival of 190 consecutive patients with a diagnosis of chronic congestive heart failure based on clinical signs and symptoms. Eur Heart J, 1994, 15(3): 303-310.
- 6. Ahmed A, Aronow WS, Fleg JL. Higher New York Heart Association classes and increased mortality and hospitalization in patients with heart failure and preserved left ventricular function. Am Heart J, 2006, 151(2): 444-450.
- 7. Tsao CW, Lyass A, Enserro D, et al. Temporal trends in the incidence of and mortality associated with heart failure with preserved and reduced ejection fraction. JACC Heart Fail, 2018, 6(8): 678-685.
- 8. Dunlay SM, Roger VL, Redfield MM. Epidemiology of heart failure with preserved ejection fraction. Nat Rev Cardiol, 2017, 14(10): 591-602.
- 9. Cincin A, Abul Y, Ozben B, et al. Pleural fluid amino-terminal brain natriuretic peptide in patients with pleural effusions. Respir Care, 2013, 58(2): 313-319.
- 10. Ather S, Chan W, Bozkurt B, et al. Impact of noncardiac comorbidities on morbidity and mortality in a predominantly male population with heart failure and preserved versus reduced ejection fraction. J Am Coll Cardiol, 2012, 59(11): 998-1005.
- 11. Mentz RJ, Kelly JP, von Lueder TG, et al. Noncardiac comorbidities in heart failure with reduced versus preserved ejection fraction. J Am Coll Cardiol, 2014, 64(21): 2281-2293.
- 12. Paulus WJ, Tschöpe C. A novel paradigm for heart failure with preserved ejection fraction: comorbidities drive myocardial dysfunction and remodeling through coronary microvascular endothelial inflammation. J Am Coll Cardiol, 2013, 62(4): 263-271.
- 13. Ponikowski P, Voors AA, Anker SD, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Kardiol Pol, 2016, 74(10): 1037-1147.
- 14. Erdei T, Smiseth OA, Marino P, et al. A systematic review of diastolic stress tests in heart failure with preserved ejection fraction, with proposals from the EU-FP7 MEDIA study group. Eur J Heart Fail, 2014, 16(12): 1345-1361.
- 15. Donal E, Lund LH, Oger E, et al. Value of exercise echocardiography in heart failure with preserved ejection fraction: a substudy from the KaRen study. Eur Heart J Cardiovasc Imaging, 2016, 17(1): 106-113.
- 16. Borlaug BA, Nishimura RA, Sorajja P, et al. Exercise hemodynamics enhance diagnosis of early heart failure with preserved ejection fraction. Circ Heart Fail, 2010, 3(5): 588-595.
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