Heart failure with preserved ejection fraction

Diastolic dysfunction
In those with HFpEF, the left ventricle of the heart (large chamber on right side of the picture) is stiffened and has impaired relaxation after pumping blood out of the heart.
SpecialtyCardiology

Heart failure with preserved ejection fraction (HFpEF) is a form of heart failure in which the ejection fraction – the percentage of the volume of blood ejected from the left ventricle with each heartbeat divided by the volume of blood when the left ventricle is maximally filled – is normal, defined as greater than 50%;[1] this may be measured by echocardiography or cardiac catheterization. Approximately half of people with heart failure have preserved ejection fraction, while the other half have a reduction in ejection fraction, called heart failure with reduced ejection fraction (HFrEF).[1]

Risk factors for HFpEF include hypertension, hyperlipidemia, diabetes, smoking, and obstructive sleep apnea.

HFpEF is characterized by abnormal diastolic function: there is an increase in the stiffness of the left ventricle, which causes a decrease in left ventricular relaxation during diastole, with resultant increased pressure and/or impaired filling.[2] There is an increased risk for atrial fibrillation and pulmonary hypertension.

There is controversy regarding the relationship between diastolic heart failure and HFpEF.[3][4]

  1. ^ a b Owan TE, Hodge DO, Herges RM, Jacobsen SJ, Roger VL, Redfield MM (July 2006). "Trends in prevalence and outcome of heart failure with preserved ejection fraction". The New England Journal of Medicine. 355 (3): 251–259. doi:10.1056/nejmoa052256. PMID 16855265.
  2. ^ Redfield MM (November 2016). "Heart Failure with Preserved Ejection Fraction". The New England Journal of Medicine. 375 (19): 1868–1877. doi:10.1056/NEJMcp1511175. PMC 4075067. PMID 27959663.
  3. ^ Zile MR (May 2003). "Heart failure with preserved ejection fraction: is this diastolic heart failure?". Journal of the American College of Cardiology. 41 (9): 1519–1522. doi:10.1016/S0735-1097(03)00186-4. PMID 12742292.
  4. ^ LeWinter MM, Meyer M (November 2013). "Mechanisms of diastolic dysfunction in heart failure with a preserved ejection fraction: If it's not one thing it's another". Circulation: Heart Failure. 6 (6): 1112–1115. doi:10.1161/CIRCHEARTFAILURE.113.000825. PMC 4558618. PMID 24255055.

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