Preserved Ejection Fraction

ABCHF

Review Article

The Role of Biomarkers in Heart Failure with Preserved Ejection Fraction

Humberto Villacorta et al. Alan S. Maisel

Introduction

A large proportion of patients with heart failure (HF) have preserved left ventricle (LV) ejection fraction (HFpEF) or slightly reduced systolic function. Although specific cutoff recommendations are constantly evolving, the European Society of Cardiology (ESC) has recently proposed the term HF with mildly reduced ejection fraction (HFmrEF) for values between 40–49% and HFpEF for ejection fraction ≥ 50%. In the past, different cutoffs were used in studies of HFpEF, ranging from 40% to 55%. Additionally, there is significant overlap between HFpEF and HFmrEF. For these reasons, in this chapter we consider them as a whole.

HFpEF is associated with many comorbidities and has a high rate of morbidity and mortality, both in ambulatory and in-hospital cohorts.^– HFpEF is a heterogeneous syndrome with diverse etiologies and phenotypes and different pathophysiological pathways, which are not fully understood.^, Circulating biomarkers may represent important tools to aid in the diagnosis and prognosis of this condition.^,

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ABCHF

Viewpoint

Physical Training in Heart Failure with Preserved Ejection Fraction

Carlos Eduardo Lucena Montenegro et al. Dilane Cristina Ferreira Tavares Fiamma Ferreira Nogueira Ana Carla Alves de Souza Lyra … Taciana Queiroz Medeiros Gomes Maria Inês Remígio de Aguiar

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ABCHF

Viewpoint

The EMPEROR-Preserved Trial: Results that Innovate the Treatment of Heart Failure with Preserved Ejection Fraction

Ricardo Mourilhe-Rocha et al. Marcelo Imbroinise Bittencourt Felipe Neves de Albuquerque Ana Luiza Ferreira Salles … Pedro Pimenta de Mello Spineti Denilson Campos de Albuquerque

The treatment of heart failure with reduced ejection fraction (HFrEF) has been improving by numerous pharmacological and non-pharmacological options, as described in national and international guidelines. However, in the scenario of patients with HF with preserved EF (HFpEF), no therapeutic update has occurred since the last published guideline.^–

Sodium-glucose cotransporter 2 (SGLT2) inhibitors are effective hypoglycemic agents in type 2 diabetes mellitus (T2DM) and are associated with improved glycemic control as well as with reduced body mass and blood pressure. In large-scale randomized trials of patients with diabetes, the use of SGLT2 inhibitors has improved cardiovascular and renal outcomes – including hospitalization for HF (HHF). This benefit was also observed in patients without diabetes who have HFrEF. That is, the presence of T2DM is not necessary to endorse the clinical benefit of SGLT2 inhibitors in HFrEF.

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ABCHF

Review Article

Cardiac Amyloidosis and Aortic Stenosis: When to Consider it and How to Treat it?

Marcelo Kirschbaum et al. Aristóteles Conte Alencar Neto Vitor Emer de Egypto Rosa Félix José Alvarez Ramires … Alexandre Antonio Cunha Abizaid Fábio Sandoli de Brito Junior Flávio Tarasoutchi Roberto Kalil Filho Fábio Fernandes

Abstract

Aortic stenosis is the most prevalent valve disease in clinical practice. The wild form of transthyretin amyloidosis has an increased incidence in elderly individuals, usually over 70 years of age. Amyloidosis and aortic stenosis are 2 diseases that affect similar populations; therefore, they may coexist in the same patient.

Patients with amyloidosis and aortic stenosis have disproportionately higher serum levels of troponin and NT-proBNP compared to patients with pure severe aortic stenosis in addition to greater ventricular hypertrophy. Therapeutic decisions for these patients must be individualized and promptly discussed by the heart team. In this article, we discuss this association and possible valve therapies, in addition to the possibility of specific treatment for amyloidosis.

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ABC

Research Letter

Emerging Topics in Heart Failure: Heart Failure With Preserved and Mid-Range Ejection Fraction

Miguel Morita Fernandes-Silva et al. Ricardo Mourilhe-Rocha Flávio de Souza Brito Antonio José Lagoeiro Jorge … Victor Sarli Issa Luiz Cláudio Danzmann

Heart Failure with Preserved Ejection Fraction (HFpEF) Diagnosis

Current diagnostic recommendations require evidence of congestion or low cardiac output, considering a combination of clinical information, electrocardiogram, imaging, biomarkers, and, in selected cases, hemodynamic exercise testing.

A pretest clinical approach (step 1) followed by a confirmatory score (step 2) is recommended to confirm or rule out the diagnosis of HFpEF. Hemodynamic exercise testing (step 3) is indicated for patients with an intermediate score ().

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The Role of Biomarkers in Heart Failure with Preserved Ejection Fraction

Introduction

Physical Training in Heart Failure with Preserved Ejection Fraction

The EMPEROR-Preserved Trial: Results that Innovate the Treatment of Heart Failure with Preserved Ejection Fraction

Cardiac Amyloidosis and Aortic Stenosis: When to Consider it and How to Treat it?

Abstract

Emerging Topics in Heart Failure: Heart Failure With Preserved and Mid-Range Ejection Fraction

Heart Failure with Preserved Ejection Fraction (HFpEF) Diagnosis

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