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What is heart failure with preserved ejection fraction? #bestcardiologistinkolathur

Heart failure with preserved ejection fraction (HFpEF) is a condition where the heart's left ventricle pumps normally but is too stiff to fill properly, causing high filling pressures and symptoms like shortness of breath and fatigue. It commonly affects older adults, often linked to hypertension, obesity, and diabetes. Management focuses on symptom relief through diuretics and addressing comorbidities, with SGLT2 inhibitors showing benefit.

Key Aspects of HFpEF

Definition & Mechanism: Formerly known as diastolic heart failure, HFpEF occurs when the heart muscle becomes stiff, limiting the amount of blood that fills the ventricle, even though the ejection fraction is normal
Symptoms: Common symptoms include dyspnea (shortness of breath) on exertion, fatigue, and fluid retention (swollen legs/ankles).
Causes & Risk Factors: The condition is highly associated with aging, female sex, hypertension, obesity, diabetes, and metabolic syndrome.
Diagnosis: Diagnosis is challenging and requires a combination of clinical symptoms, echocardiographic evidence of diastolic dysfunction (e.g., elevated filling pressures, left atrial enlargement), and, in some cases, high levels of natriuretic peptides, though these may be normal in some patients, particularly those with obesity.
Treatment: Management aims to improve quality of life and reduce hospitalizations, as no treatment has definitively shown a significant reduction in mortality. Strategies include:
- Diuretics: To manage fluid congestion and reduce symptoms.
- SGLT2 Inhibitors: Recommended to reduce the risk of cardiovascular death and heart failure hospitalization.
- Lifestyle Changes: Weight loss, sodium restriction, and regular exercise.
- Comorbidity Management: Aggressive control of hypertension, atrial fibrillation, and diabetes.

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