Prognosis in heart failure with preserved ejection fraction

ABSTRACT

Heart Failure with preserved Ejection Fraction (HFpEF), like other heart failure syndromes, is heterogeneous in etiology and pathophysiology, rather than a single disease. HFpEF may account for about half of all patients with heart failure. Patients have symptoms and signs of HF with normal or near normal left ventricular EF (LV EF>50 %). The classical risk factors for developing HFpEF include advanced age and co-morbidities, notably hypertension, atrial fibrillation, and the metabolic syndrome. When complicated by increasing congestion requiring hospital admission, the prognosis is poor; 30% or more of such patients will die within 1 year (nearly two-thirds die from cardiovascular causes). Patients with chronic stable symptoms have a better prognosis. Patients with HFpEF represent an important group of patients presenting in clinical practice with HF. Overall, it appears that patients with HFpEF are at lower risk of death than patients with HFrEF, although mortality remains high in both groups. Application of the same therapeutic hypotheses that have been successfully utilized among patients with HFrEF have not been demonstrated to result in improved survival