HFpEF: Evidence from Recent Clinical Trials and New Perspectives

Heart failure (HF) is a highly prevalent clinical syndrome affecting more than 10% of the population older than 70 years of age, with a great impact on morbidity and mortality.^, HF is traditionally divided into three categories based on the left ventricular ejection fraction (EF): HF with reduced EF (EF50%; HFpEF).

HFpEF represents nearly half of HF cases in developed countries; its pathophysiology is complex and still little understood. The great variety of HFpEF phenotypes, makes its diagnosis and treatment challenging. Unlike HFrEF, before the emergence of SGLT-2 inhibitors, no treatment had been shown effective in reducing the hard outcomes in HFpEF. Also, the wide variability in diagnostic criteria of HFpEF adopted in different clinical trials may have contributed to the difficulty in showing therapeutic effectiveness in reducing mortality.

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