From the Guidelines
Management of heart failure with preserved ejection fraction (HFpEF) focuses on symptom relief, treating underlying conditions, and improving quality of life, with a comprehensive approach including risk stratification, management of comorbidities, nonpharmacological management, and symptom management with disease-modifying therapy, as recommended by the 2023 ACC expert consensus decision pathway 1. The management of HFpEF involves a multifaceted approach, including:
- Risk stratification and management of comorbidities, such as hypertension, diabetes, obesity, atrial fibrillation, coronary artery disease, chronic kidney disease, and obstructive sleep apnea
- Nonpharmacological management, including the role of exercise and weight loss, and the use of wireless, implantable pulmonary artery monitors
- Symptom management and disease-modifying therapy with loop diuretic agents, SGLT2 inhibitors, mineralocorticoid antagonists, angiotensin receptor–neprilysin inhibitors, and angiotensin receptor blockers Key pharmacological treatments include:
- Diuretics, such as loop diuretics like furosemide or torsemide, to reduce fluid overload and relieve congestion
- SGLT2 inhibitors, such as empagliflozin or dapagliflozin, which have shown benefit in reducing hospitalizations and cardiovascular death 1
- Blood pressure control with ACE inhibitors, ARBs, or calcium channel blockers to maintain targets below 130/80 mmHg Lifestyle modifications are also crucial, including:
- Sodium restriction (<2g daily)
- Regular physical activity
- Weight management
- Treatment of comorbidities like diabetes, obesity, and sleep apnea, which contribute to HFpEF progression It is essential to note that traditional neurohormonal antagonists have not shown significant mortality benefits in HFpEF, making symptom management and addressing underlying causes the cornerstone of therapy 1.
From the Research
Management of Heart Failure with Preserved Ejection Fraction (HFpEF)
There are no research papers to assist in answering this question, as the provided studies focus on the management of high-flow priapism, a condition unrelated to HFpEF.
- The studies 2, 3, 4, 5, 6 discuss the diagnosis, treatment, and management of high-flow priapism, including selective arterial embolization, conservative management, and surgical intervention.
- These studies do not provide information on the management of HFpEF, which is a condition characterized by the heart's inability to relax and fill properly during diastole, leading to increased pressure and fluid buildup in the lungs.
- Further research is needed to provide evidence-based guidance on the management of HFpEF.