Echocardiography in Heart Failure with Preserved Ejection Fraction: From Primary Care to Tertiary Hospitals

Introduction

Heart failure (HF) is a highly prevalent and incident clinical syndrome that mostly affects older adults. It is one of the main causes of hospital admission, which is a strong prognostic marker, considering that approximately 50% of hospitalized patients will be readmitted within 6 months.

HF with preserved ejection fraction (HFpEF) is hemodynamically defined as an inability of the heart to meet adequate metabolic demands under normal filling pressures. This concept is fundamental, given that patients with normal left ventricular (LV) ejection fraction (EF) (> 50%) usually have normal cardiac output, but are only able to maintain this output at the expense of increased filling pressures. Some patients are known to show signs of congestion at rest, but the vast majority only presents clinical symptoms during effort.

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