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Deprecated: Implicit conversion from float 245.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Circ+Res 2014 ; 115 (1): 79-96 Nephropedia Template TP
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Unmet Needs in Cardiovascular Science and Medicine: Heart Failure with Preserved Ejection Fraction: Mechanisms, Clinical Features, and Therapies #MMPMID24951759
Sharma K; Kass DA
Circ Res 2014[Jun]; 115 (1): 79-96 PMID24951759show ga
The clinical syndrome comprised of heart failure symptoms but with a left ventricular ejection fraction that is not diminished, e.g. heart failure with a preserved ejection fraction (HFpEF), is increasingly the predominant form of HF in the developed world, and soon to reach epidemic proportions. It remains among the most challenging of clinical syndromes for the practicing clinician and scientist alike, with a multitude of proposed mechanisms involving the heart and other organs and complex interplay with common co-morbidities. Importantly, its morbidity and mortality is on par with heart failure and a reduced ejection fraction, and as the list of failed treatments continues to grow, HFpEF clearly represents a major unmet medical need. The field is greatly in need of a more unified approach to its definition and view of the syndrome that engages integrative and reserve pathophysiology beyond that related to the heart alone. We need to reflect on prior treatment failures and the message this is providing, and re-direct our approaches likely with a paradigm shift in how the disease is viewed. Success will require interactions between clinicians, translational researchers, and basic physiologists. Here, we review recent translational and clinical research into HFpEF, give perspectives on its evolving demographics and epidemiology, the role of multi-organ deficiencies, potential mechanisms that involve the heart and other organs, clinical trials, and future directions.