Diagnosis and treatment of heart failure with preserved ejection fraction

Background Heart failure, a primary worldwide public health burden, is a complicated clinical syndrome manifested in hemodynamic and symptomatic changes. There are 2 subtypes of heart failure, with ejection frac tion preserved(HFpEF) and reduced(HFrEF). The morbidity of HFpEF derived from epidemic data account for 50% of total HF patients which is expected to continuously increase with the increase of elderly population in the future. The relevant risk factors for HFpEF include aging, female gender, hypertension, ischemic heart dis ease, atrial fibrillation and diabetes mellitus. The essence of HFpEF is recognized as an increase in left ventricu lar filling pressure implicated in certain interlinked physiological systems. The treatments are mainly aimed to re lieve the symptoms and control risk factors such as anti-hypertension, prevention of myocardial ischaemia, ve nous pressure reduction, management of atrial fibrillation and management of diabetes. In addition, some new treatments are being tested in clinical trails such as phosphodiesterase- 5(PDE5) inhibitor, tetrahydrobiopterin(BH4), late Na current inhibitor, cardiac resynchronization therapy and angiotensin receptor neprilysin inhibito LCZ696. Here, we briefly review the diagnosis and treatment in heart failure with preserved ejection fraction