Of the millions of heart failure heart failure patients worldwide, approximately half present with preserved left ventricular ejection fraction (HFPEF). HFPEF has high rates of morbidity and mortality, yet therapy remains empirical due to incomplete understanding of disease pathophysiology. Systemic hypertension is the most prominent risk factor for HFPEF. Patients often have multiple other comorbid conditions, which may contribute to symptom burden and the HFPEF syndrome itself. The classic paradigm of ventricular diastolic dysfunction has expanded, and vascular dysfunction likely contributes to HFPEF in many patients. Pressure-volume loop analysis identifies three distinct hemodynamic phenotypes for HFPEF, a finding which may have significant implications for clinical trial enrollment and individual patient treatment.
BackgroundTelomere defects are thought to play a role in cardiomyopathies, but the specific cell type affected by the disease in human hearts is not yet identified. The aim of this study was to sys...
The diagnosis of heart failure with preserved ejection fraction (HFPEF) remains on the basis of echocardiographic analyses at rest. However, some patients with HFPEF have symptoms such as dyspnea only during exercise. Accordingly, echocardiographic analyses at rest could be insufficiently sensitive to identify these patients. In line, recent studies demonstrated that in some patients with HFPEF left ventricular diastolic abnormalities occur only during exercise. This review discusses and analyzes the clinical relevance and evidence of using diastolic stress test echocardiography in patients with HFPEF.