Does HFpEF Really Exist? From Mimics to Misclassification in Clinical Practice

Dear Editor,

I read with interest the recent article by Villacorta et al. addressing the distinction between “true” heart failure with preserved ejection fraction (HFpEF) and conditions that merely mimic it. Their effort to clarify this conceptual ambiguity is commendable and timely. However, I believe the issue extends further, even when HFpEF mimics such as amyloidosis, constrictive pericarditis, or severe valvular disease are carefully excluded, the clinical entity known as HFpEF often dissolves under closer scrutiny.

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