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Praxis (Bern 1994). 2013 Oct 16;102(21):1299-307. doi: 10.1024/1661-8157/a001439.

[Heart failure with preserved left ventricular ejection fraction].

[Article in German; Abstract available in German from the publisher]

Author information

1
Fachbereich Kardiologie, Kantonsspital St. Gallen.

Abstract

in English, French, German

Heart failure with preserved left ventricular ejection fraction (LVEF; HFpEF) is a common type of heart failure in the elderly, and it typically represents advanced hypertensive heart disease. The left ventricle in patients with HFpEF is characterized by concentric remodeling, normal LVEF, but reduced left longitudinal shortening, and importantly diastolic dysfunction. Dyspnoe and fatigue in patients with HFpEF are due to impaired left ventricular filling with a rapid increase in filling pressures and the lack of an increase in stroke volume during exercise. The diagnosis of HFpEF requires the careful exclusion of non-cardiac causes of dyspnoe as well as cardiac causes of dyspnoe associated with preserved LVEF other than HFpEF, primarily coronary artery disease and valve disease. Then, the following findings are required to make a diagnosis of HFpEF: a non-dilated left ventricle with an LVEF >50% and the presence of a significant diastolic impairment, which can be assessed using invasive haemodynamics, echocardiography, natriuretic peptides, or a combination of these tools. In contrast to patients with heart failure and reduced LVEF there is still no established treatment for patients with HFpEF, which prolongs survival or reduces the rate of hospitalizations for heart failure. There is currently however intense research going on in this field, and results from large trials evaluating the effects of various interventions on clinical endpoints are expected within the next years.

KEYWORDS:

Auswurffraktion; Herzinsuffizienz; diastolic; diastolisch; dysfonction diastolique; ejection fraction; erhalten; fonction systolique préservée; fraction d'éjection; heart failure; insuffisance cardiaque; normal; preserved

PMID:
24129298
DOI:
10.1024/1661-8157/a001439
[Indexed for MEDLINE]

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